J Korean Neurosurg Soc.  2013 Aug;54(2):132-135. 10.3340/jkns.2013.54.2.132.

Differential Diagnosis and Management of a Pituitary Mass with Renal Cell Carcinoma

• Hwang JM
• Kim YH
• Kim TM
• Park SH

• KMID: 1814251
• DOI: http://doi.org/10.3340/jkns.2013.54.2.132

Abstract

The small pituitary mass was incidentally found in 40-years-old women with renal cell carcinoma. The endocrinological and ophthalmological evaluation revealed no deficit and the short-term follow-up was recommended. In 6 months later, the visual disturbance was reported and the size of mass was increased. The tumor was removed totally via the trans-sphenoid approach. The post-operative endocrinological insufficiency was not noticed. During one year of follow-up period, there was no evidence of recurrence without adjuvant radiotherapy. The clinical features of pituitary metastasis from renal cell carcinoma were similar to those of pituitary adenoma. The possibility of pituitary metastasis should be kept in mind in patients with sellar mass and renal cell carcinoma.

Keyword

Pituitary; Metastasis; Renal cell carcinoma

MeSH Terms

Carcinoma, Renal Cell
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Neoplasm Metastasis
Pituitary Neoplasms
Radiotherapy, Adjuvant
Recurrence

Figure

• 

  Fig. 1 The T1-weighted coronal (A) and sagittal (B) magnetic resonance images used to evaluate the intermittent headache reveal a round, well-enhanced sellar mass. The pituitary stalk is slightly deviated to the left by the tumor, and no optic compression is noted. 18F-fluorodeoxyglucose positron emission tomography shows no increased uptake in the sellar mass (C) in contrast to the other metastatic lesions in the body (D).

• 

  Fig. 2 The T1-weighted coronal (A) and sagittal (B) magnetic resonance images taken 6 months later show the markedly growing sellar mass compressing the optic chiasm.

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  Fig. 3 The tumor was gray and moderately hard (A). It has a sharp margin between the pituitary gland (B) and the diaphragma sellae (C). The dissection plane between the tumor and the surrounding normal structures is not strongly adhesive.

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  Fig. 4 The pathologic examination shows a nest of epithelial cells with clear cytoplasms and distinct cell membranes. The nests are separated by the highly vascularized stroma. Hematoxylin and eosin staining (×200).

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