Kruljac Ivan, Sulentić Petra, Cigrovski-Berković Maja, Petrović Vinka, Pećina Hrvoje Ivan, Cerina Vatroslav, Houra Karlo, Pazanin Leo, Vrkljan Milan
Department of Endocrinology, Diabetes and Metabolic Diseases, University Department of Medicine, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Acta Clin Croat. 2010 Sep;49(3):347-51.
Intracranial metastases from laryngeal carcinoma are rarely clinically diagnosed. To our knowledge, this is the first report of hypopituitarism due to pituitary metastasis from laryngeal carcinoma. We report on a 70-year-old man who had a supraglottic squamous cell carcinoma, which was resected surgically followed by local full dose radiation therapy. Four months later, he presented with a sudden onset of diplopia, syncope, headache, general malaise and loss of appetite. Magnetic resonance imaging of the brain revealed a tumorous process of the sellar region. Endocrinological tests disclosed the presence of hypopituitarism. The tumor was subtotally resected endoscopically via endonasal transsphenoidal approach. Histopathology of tumor specimens indicated squamous cell carcinoma. Tumors of the sellar and parasellar region as in the case presented may easily be confused with pituitary adenoma. Pituitary metastases should be considered on differential diagnosis of unusual pituitary tumors, especially in patients with as well as in those without a history of malignant disease.
喉癌的颅内转移在临床上很少被诊断出来。据我们所知，这是首例因喉癌垂体转移导致垂体功能减退的报告。我们报告了一名70岁男性，他患有声门上鳞状细胞癌，接受了手术切除，随后进行了局部全剂量放射治疗。四个月后，他突然出现复视、晕厥、头痛、全身不适和食欲不振。脑部磁共振成像显示蝶鞍区有肿瘤病变。内分泌检查发现存在垂体功能减退。通过鼻内镜经蝶窦入路对肿瘤进行了次全切除。肿瘤标本的组织病理学检查显示为鳞状细胞癌。如本病例所示的蝶鞍和鞍旁区域肿瘤很容易与垂体腺瘤混淆。在鉴别诊断不常见的垂体肿瘤时，应考虑垂体转移瘤，特别是在有和没有恶性疾病病史的患者中。
