[Pituitary metastases. 3 cases].

OBJECTIVE

Review cases with hyothalamo-hypophyseal metastases which raise complex therapeutic situations.

PATIENTS AND METHODS

Files of patients hospitalized from 1992 to 1996 at the Cochin Hospital Endocrinology unit were compared with data reported in the literature.

RESULTS

We had patients with pituitary metastases from breast cancer and 69 cases have been reported in the literature: 72 patients, 57% men and 43% women, mean age 57.2 +/- 12.3 years. The primary tumor was identified in 58.3% of the cases. The primary cancer was unknown and revealed by the pituitary metastasis in 41.7% of the cases. The primary tumor was a breast cancer in 31.9% of the cases, and lung cancer in 30.5%. The main clinical signs were vision disorders (40.3%) and diabetes insipisus (29.1%). The principal differential diagnosis was hypophyseal adenoma. Short term prognosis was not good.

DISCUSSION

These data are in agreement with the older literature excepting the high prevalence of primary cancers revealed by pituitary metastasis, probably a result of progress in hypophyseal exploration techniques.

CONCLUSION

The prevalence of pituitary metastasis will continue to increase with longer survival in cancer patients. Metastasis should thus be entertained as a possibility in patients with a hypothalamo-hypophyseal tumor, particularly after the age of 59, in order to hasten diagnosis and provide early treatment.