Gur Chamutal, Lalazar Gadi, Salmon Asher, Dubiner Victoria, Gross David J
Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Pituitary. 2008;11(3):293-7. doi: 10.1007/s11102-007-0053-7.
Neuroendocrine tumor metastases to the pituitary gland are very rare. There are few case reports of carcinoid tumor metastases to the pituitary, but no cases of pancreatic neuroendocrine pituitary metastases have been reported. In this report we present a 55-year-old female with a sellar mass, ophthalmoplegia and headaches initially thought to represent an invasive null cell pituitary adenoma. However a histological (trans-sphenoidal and liver biopsies) and systemic investigation proved it to be a metastasis of an undiagnosed pancreatic neuroendocrine tumor. Our patient was unique in respect to the location of the metastasis and the uncharacteristically high proliferative index of her tumor. She received conventional therapy consisting of Sandostatin, chemotherapy and radiotherapy as well as labeled somatostatin following an avid uptake on octreotide scanning. Despite a radiological improvement the patient suffered progressive clinical deterioration and died.
神经内分泌肿瘤转移至垂体非常罕见。类癌转移至垂体的病例报告较少,而胰腺神经内分泌肿瘤转移至垂体的病例尚无报道。在本报告中,我们介绍了一名55岁女性,其蝶鞍区有肿物,伴有眼肌麻痹和头痛,最初被认为是侵袭性无功能垂体腺瘤。然而,组织学检查(经蝶窦活检和肝脏活检)及全身检查证实这是一例未确诊的胰腺神经内分泌肿瘤的转移灶。我们的患者在转移部位及肿瘤异常高的增殖指数方面具有独特性。她接受了包括善龙、化疗、放疗以及奥曲肽扫描显示摄取活跃后给予的标记生长抑素在内的常规治疗。尽管影像学上有所改善,但患者临床病情仍逐渐恶化并死亡。