Department of Endocrinology and Diabetes, Farhat Hached University Hospital, Sousse, Tunisia.
Department of Carcinology, Farhat Hached University Hospital, Sousse, Tunisia.
J Cancer Res Ther. 2024 Jan 1;20(1):496-499. doi: 10.4103/jcrt.jcrt_224_21. Epub 2024 Mar 29.
Metastasis to pituitary gland is a rare condition, and patients are usually asymptomatic. Diabetes insipidus (DI) is the most common presenting symptom, and breast cancer is the most common source of pituitary metastasis (PM). We report a case of PM of breast cancer presenting as DI. A 45-year-old female patient presented to our department with complaints of polyuria and polydipsia. She had a medical history of metastatic breast adenocarcinoma. Laboratory data showed normal fasting plasma glucose level and hypotonic urine. Brain magnetic resonance imaging (MRI) showed infiltration of the pituitary stalk and the absence of the posterior pituitary bright spot consistent with metastasis to the pituitary gland. The water deprivation and vasopressin challenge tests confirmed central DI. Pituitary function tests revealed disconnection hyperprolactinemia with a menopausal profile. The patient was treated with vasopressin with great clinical results. Pituitary metastases are rare but should be suspected in patients with metastatic cancer who present with DI.
垂体转移是一种罕见的情况，患者通常无症状。最常见的表现症状为尿崩症（DI），而乳腺癌是垂体转移（PM）最常见的来源。我们报告了一例以 DI 为表现的乳腺癌 PM 病例。一名 45 岁女性患者因多尿和多饮就诊于我科。她患有转移性乳腺腺癌病史。实验室数据显示空腹血糖水平正常，尿液低渗。脑磁共振成像（MRI）显示垂体柄浸润，无后叶垂体亮点，符合垂体转移。禁水和血管加压素刺激试验证实为中枢性 DI。垂体功能检查显示催乳素分离性高分泌，具有绝经后特征。患者接受了血管加压素治疗，取得了很好的临床效果。垂体转移虽然罕见，但对于患有转移性癌症并出现 DI 的患者，应怀疑有垂体转移。
