Pituitary metastases: a case series

Luigi Demarchis; Sabrina Chiloiro; Antonella Giampietro; Mattogno Pier Paolo; Rosalinda Calandrelli; Liverana Lauretti; Marco Gessi; Guido Rindi; Marinis Laura De; Francesco Doglietto; Antonio Bianchi; Alfredo Pontecorvi

doi:10.1530/endoabs.110.EP1103

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Endocrine Abstracts (2025) 110 EP1103 | DOI: 10.1530/endoabs.110.EP1103

ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)

Pituitary metastases: a case series

Luigi Demarchis ¹ , Sabrina Chiloiro ¹ , Antonella Giampietro ¹ , Pier Paolo Mattogno ² , Rosalinda Calandrelli ³ , Liverana Lauretti ² , Marco Gessi ⁴ , Guido Rindi ⁴ , Laura De Marinis ¹ , Francesco Doglietto ² , Antonio Bianchi ¹ & Alfredo Pontecorvi ¹

Author affiliations

¹Division of Endocrinology and Metabolism, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli, IRCCS, Endocrinology and Diabetology, Rome, Italy; ²Institute of Neurosurgery, Facoltà di Medicina e Chirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Rome, Italy; ³ARC Advanced Radiology Center (ARC), Department of Oncological Radiotherapy, and Hematology, Facoltà di Medicina e Chirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, Rome, Italy; ⁴Anatomic Pathology Unit, Department of Woman and Child Health Sciences and Public Health, Facoltà di Medicina e Chirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

JOINT2989

Background: Pituitary metastases are a rare pathological finding. This case series aims to evaluate certain variables in patients with pituitary metastases.

Methods: We performed a retrospective analysis of pituitary metastasis patients who came to our center from 2018 to 2023. All patients underwent pituitary MRI and the diagnosis of pituitary metastasis was confirmed by histological examination.

Results: We identified 10 patients of whom 7 were female and 3 male, with a mean age of 56.7 years. The histological features of the neoplasms found were: breast carcinoma (2), neuroendocrine tumors of probable lung origin (2), adnexal carcinoma (1), gastrointestinal carcinoma (1), melanoma (1), small cell lung carcinoma (1), thyroid carcinoma (1), diffuse large cell non-Hodgkin’s lymphoma (1). Visual disturbances were the most frequent onset symptom (30%). A prolactin elevation was found in one patient. All patients underwent trans-sphenoidal surgery to debulk, reduce and/or resolve symptoms and restore proper hormone secretion. In 60% of the patients residual disease was found at post-operative radiological control. In the postoperative period, 70% of patients had a deficit in the secretion of pituitary hormones: anterior hypopituitarism (4 patients) and diabetes insipidus (3 patients) were the most frequent. Only 3 patients (30%) had no deficits in hormone secretion after undergoing transsphenoidal surgery. In 30% of the patients, the pituitary gland was identified as the first site of metastasis. In one patient, suffering from neuroendocrine carcinoma, the primary neoplasm was not found.

Conclusion: Pituitary metastases are characterized by great heterogeneity in clinical presentation, hormonal deficits, and origin of the primary neoplasm. Generally, this type of lesion is treated as an adenoma; only after the lesion is removed and histological examination is performed can it diagnose pituitary metastasis. An interesting finding from this series is that in 3 patients the pituitary gland was identified as the primary site of metastasis, with no evidence of metastatic disease in other districts. Surgery represents the first line of therapy. The rate of residual or recurrence of disease after surgery remains considerable.