Dagher Samir A, Alizada Sahar, Al Qudah Heba, Waguespack Steven G, Shah Komal B, Eldaya Rami W
Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, USA.
Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, USA.
Neuroradiol J. 2025 Jun 27:19714009251356278. doi: 10.1177/19714009251356278.
PurposeMetastatic pituitary neuroendocrine tumors (PitNET) are exceedingly rare tumors that are typically diagnosed at the time of metastasis. Given the rarity of metastatic PitNET tumors, the pattern of metastasis and imaging appearance of CNS and extra neural metastasis is under reported and poorly understood.MethodsIn this retrospective case series, we present 14 consecutive patients with pathology-confirmed metastatic PitNET tumors. We assess imaging features of primary pituitary disease at the time of diagnosis, temporal evolution of local disease, and distant metastasis on multimodality imaging. We also explore potential association of initial pathology diagnosis and time to metastasis and survival.ResultsAt the time of metastasis, nine patients had evidence of disease in the sella and three additional had evidence of disease in the cavernous sinus. The most common site of metastatic disease was the CNS (78.6%). Dural deposits were the most common brain CNS metastatic disease manifestation (81.8%). Eight patients (57.1%) demonstrated multiple metastatic disease sites, with five of them (62.5%) showing both CNS and extra CNS metastases. Osseous metastatic disease was the most common extra CNS disease site (75.0%). Median time to metastasis did not significantly differ between patients with adenoma and those with more aggressive pathologies at initial diagnosis ( value = .39). Similarly, median overall survival from metastasis detection was not significantly affected by pathology ( value = .84).ConclusionMetastatic PitNET is a rare neuroendocrine neoplasm. In the present case series, we detail temporal imaging findings of the disease at the primary site and patterns of metastasis.
目的
转移性垂体神经内分泌肿瘤（PitNET）极为罕见，通常在转移时才被诊断出来。鉴于转移性PitNET肿瘤的罕见性，中枢神经系统（CNS）和神经外转移的转移模式及影像学表现报道不足且了解甚少。
方法
在这个回顾性病例系列中，我们呈现了14例经病理证实的转移性PitNET肿瘤患者。我们评估了诊断时原发性垂体疾病的影像学特征、局部疾病的时间演变以及多模态影像学上的远处转移情况。我们还探讨了初始病理诊断与转移时间及生存之间的潜在关联。
结果
在转移时，9例患者蝶鞍有疾病证据，另外3例海绵窦有疾病证据。转移性疾病最常见的部位是CNS（78.6%）。硬脑膜沉积是最常见的脑CNS转移性疾病表现（81.8%）。8例患者（57.1%）表现为多个转移病灶部位，其中5例（62.5%）既有CNS转移又有CNS外转移灶。骨转移性疾病是最常见的CNS外疾病部位（75.0%）。腺瘤患者与初始诊断时病理类型更具侵袭性的患者之间，转移的中位时间无显著差异（P值 = 0.39）。同样，从检测到转移开始计算的中位总生存期不受病理类型的显著影响（P值 = 0.84）。
结论
转移性PitNET是一种罕见的神经内分泌肿瘤。在本病例系列中，我们详细阐述了该疾病在原发部位的时间影像学表现及转移模式。
