We are presenting a case report of 82-year-old patient admitted at Cork University Hospital on 3 July 2015 for investigation of complete ptosis and ophthalmoplegia of left eye which had occurred in couple of weeks time. Initially patient was referred to ophthalmology department by his GP and ophthalmologist found left ophthalmopathy with complete ptosis and referred patient to medical for stroke work up. CT Brain showed abnormal mass in pituitary fossa. MRI Pituitary showed multiple small lesion involving pituitary and impression of metastatic disease was given.
Chest X-ray showed left hilar mass and subsequent CT showed left lilar mass encasing main pulmonary artery with metastatic to pleura and liver with widespread mediastinal lymph adenopathy.
Transbronchial Biopsy showed small cell carcinoma of lung with stage IV disease. After multidisciplinary meeting concluded palliative treatment. He was given cranial and thorax radiotherapy. He did not tolerated chest radiotherapy. After 4 cycles of cranial radiotherapy, there was 25% improvement in his ptosis. His hospital course was complicated by aspiration pneumonia which settled after broadspectrum antibiotics. He was then transferred to Marymount University Hospital and Hospice, Cork. He developed fracture at the junction of the superior pubic ramus and acetabulum and right inferior pubic ramus. He was seen by orthopedic team and advised conservative treatment. He passed away on 27 August 2015.
Keywords: pituitary metastases, small cell carcinoma, palliative radiotherapy
17 - 19 Feb 2016
European Society of Endocrinology