Section of Endocrinology, ASL6, Viale Alfieri 36, Livorno, Italy.
Endocrine. 2013 Jun;43(3):485-93. doi: 10.1007/s12020-012-9806-9. Epub 2012 Sep 26.
Pituitary metastases (PM) from thyroid cancer are rare, but their management can represent a difficult challenge for the endocrinologist. Our aim was to review all reported cases of PM from thyroid cancer. PubMed was consulted and 19 papers reporting 20 cases were found. We moreover discuss two of our own cases, which had come to our attention within a few months of one another. Eleven cases were follicular cancer, eight cases were papillary cancer, two cases were medullary cancer, and one case was an insular cancer. In nine cases, PM was the first sign of the disease. Cranial nerve involvement was the most common sign of its presence, and no neuroradiological imaging could lead to a sure diagnosis of PM. Neurosurgical intervention was performed in almost all cases, and post-surgical treatment comprised radioiodine, external beam radiotherapy, and radiosurgery. Prognosis was poor for larger metastases, cranial nerve palsy disappeared in only one case, and in only one case of intrasellar metastasis was the disease cured. PM from thyroid cancer are rare, but are burdened by a poor prognosis. An early diagnosis appears important, and a comprehensive strategy for treatment (neurosurgery, radioiodine, external radiotherapy, and radiosurgery) appears advisable.
垂体转移瘤（PM）来自甲状腺癌较为罕见，但对内分泌学家而言，其管理可能极具挑战性。我们旨在回顾所有报道的甲状腺癌 PM 病例。查阅了 PubMed，并发现了 19 篇报告 20 例病例的论文。此外，我们还讨论了我们自己的两个病例，这两个病例在彼此相隔数月的时间里引起了我们的注意。11 例为滤泡癌，8 例为乳头状癌，2 例为髓样癌，1 例为胰岛细胞癌。9 例 PM 是疾病的首发表现。颅神经受累是其存在的最常见征象，且无神经影像学检查可明确诊断 PM。几乎所有病例均进行了神经外科干预，术后治疗包括放射性碘、外照射放疗和放射外科治疗。对于较大的转移灶，预后较差，仅 1 例颅神经麻痹消失，仅 1 例鞍内转移病例治愈。甲状腺癌 PM 较为罕见，但预后较差。早期诊断似乎很重要，全面的治疗策略（神经外科、放射性碘、外照射放疗和放射外科治疗）似乎是合理的。
