Poullin P, di Costanzo V, Le Pommelet C, Gabriel B
Service de médecine interne, CHU La Conception, Marseille, France.
Rev Med Interne. 1995;16(6):444-6. doi: 10.1016/0248-8663(96)80737-5.
We are reporting on a case of diabetes insipidus (DI) and anterior pituitary failure revealing a breast cancer metastasis. Ten years after being diagnosed with a unilateral breast cancer, the patient presented with asthenia, thirst, polyuria and nocturia improved by subcutaneous DDAVP. MRI revealed a thickened pituitary stalk. DI is uncommon, late and usually asymptomatic in breast cancer. The association with an anterior pituitary failure is even more rare. In our patient the metastasis is in the pituitary stalk and seems to be due to meningeal deposits. MRI appears to be the best procedure to perform, showing a thickening stalk. Extension to the pituitary gland is related to direct tumor invasion from adjacent structures rather than haematogenous spread.
我们报告了一例尿崩症（DI）和垂体前叶功能减退病例，发现存在乳腺癌转移。在被诊断为单侧乳腺癌十年后，患者出现乏力、口渴、多尿和夜尿症状，皮下注射去氨加压素后症状改善。磁共振成像（MRI）显示垂体柄增粗。尿崩症在乳腺癌中并不常见，出现较晚且通常无症状。与垂体前叶功能减退同时存在的情况更为罕见。在我们的患者中，转移灶位于垂体柄，似乎是由于脑膜浸润所致。MRI似乎是最佳的检查方法，可显示垂体柄增粗。向垂体腺的扩展与肿瘤从相邻结构的直接侵犯有关，而非血行播散。
