ODP345 Pituitary Metastasis from Clear Cell Renal Cell Carcinoma

A 63-year-old female presented with a two month history of intermittent diplopia and headaches. Her past medical history was relevant for renal carcinoma status post right nephrectomy four years prior, she did not receive any adjuvant therapy. She underwent MRI brain which showed a 2.1×2. 0×1.6 cm sellar/suprasellar enhancing mass with mass effect on the optic chiasm and extending into the right cavernous sinus, consistent with pituitary macroadenoma. Visual field testing was also done showing mild bitemporal quadrantanopia. Lab evaluation did not show evidence of pituitary hormone excess or deficiency. Serum sodium was normal, IGF-1 117 ng/ml (reference range 35-201 ng/ml), GH 0.19 ng/ml (0. 01 -3.61 ng/ml), alpha subunit 0.4 ng/ml (<1.8 in postmenopausal females), ACTH 15 pg/ml (7-63 pg/ml), prolactin 20.8 ng/ml (3.3 -26.7 ng/ml), TSH 2.36 MCU/ml (0.35-5 MCU/ml) and FT4 0.9 ng/dl (0.6 -1.6 ng/dl). Neurosurgery evaluated the patient and she underwent transsphenoidal surgery. Her postoperative period was unremarkable without evidence of diabetes insipidus or secondary adrenal insufficiency. Final pathology revealed clear cell lesion/carcinoma consistent with metastatic renal cell carcinoma. Transcription marker testing was positive for SF1, consistent with a gonadotroph pituitary adenoma. Presentation: No date and time listed