Metastases to the pituitary gland

Pituitary metastasis is a rare cause of an intrasellar mass. The authors report a series of 52 patients with intrasellar metastases diagnosed between 1950 and 1996. The patient group included 29 women and 23 men with a mean age of 60 years. Breast and lung carcinomas were the most frequent primary tumors (37% and 23%, respectively). The primary tumor was unknown in 12% of patients. In the patients with a known primary tumor, it was diagnosed after the pituitary metastasis was discovered in 20%. The mode of discovery of pituitary metastases was symptom-based (visual impairment, diabetes insipidus, hypopituitarism) in 75% of patients. Of the patients in whom prolactin was measured, 63% had hyperprolactinemia. Computed tomography and magnetic resonance imaging of the brain, available for 52% and 19% of patients, respectively, showed a pituitary mass in each case. Pituitary surgery and radiotherapy were performed in 42% and 63% of patients, respectively. Mean survival was 17 months (range, 0-240 months). Overall mortality at 1 year was 67%.