Department of Ophthalmology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.
J Clin Neurosci. 2010 Jun;17(6):790-3. doi: 10.1016/j.jocn.2009.09.044. Epub 2010 Apr 9.
Pituitary gland metastases, albeit rare, remain an important differential in sellar and suprasellar tumours. Clinical and radiological features of pituitary metastases may be indistinguishable from benign suprasellar lesions such as a pituitary adenoma. Histopathology with immunohistochemical assay remains the key to the diagnosis of pituitary metastasis. We describe four patients with sellar lesions presenting with anterior visual pathway compression initially diagnosed as pituitary adenomas who on immunohistochemistry were found to have metastases to the pituitary. Classification of the cell histology determined the primary site of origin in some patients. This series demonstrates the importance of combining histopathology and immunohistochemistry in the diagnosis of suprasellar lesions.
垂体转移瘤虽然罕见,但在鞍区和鞍上肿瘤中仍然是一个重要的鉴别诊断。垂体转移瘤的临床和影像学特征可能与良性鞍上病变如垂体腺瘤无法区分。组织病理学检查结合免疫组织化学检查仍然是诊断垂体转移瘤的关键。我们描述了 4 例表现为鞍区病变并伴有前视路受压的患者,最初诊断为垂体腺瘤,免疫组织化学检查发现为垂体转移瘤。在某些患者中,细胞组织学分类确定了原发部位。本系列研究表明,在鞍上病变的诊断中,组织病理学和免疫组织化学相结合的重要性。