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Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma

INTRODUCTION: Pituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor. METHODS: We present the case of a 58 years-old-man who repo...

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Autores principales: Ghezzi, Andrea, Rossi, Jessica, Cavallieri, Francesco, Napoli, Manuela, Pascarella, Rosario, Rizzi, Romana, Russo, Marco, Salomone, Gaetano, Romano, Antonio, Iaccarino, Corrado, Froio, Elisabetta, Serra, Silvia, Cozzi, Salvatore, Giaccherini, Lucia, Valzania, Franco, Pisanello, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846627/
https://www.ncbi.nlm.nih.gov/pubmed/36686817
http://dx.doi.org/10.3389/fonc.2022.1059361
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author Ghezzi, Andrea
Rossi, Jessica
Cavallieri, Francesco
Napoli, Manuela
Pascarella, Rosario
Rizzi, Romana
Russo, Marco
Salomone, Gaetano
Romano, Antonio
Iaccarino, Corrado
Froio, Elisabetta
Serra, Silvia
Cozzi, Salvatore
Giaccherini, Lucia
Valzania, Franco
Pisanello, Anna
author_facet Ghezzi, Andrea
Rossi, Jessica
Cavallieri, Francesco
Napoli, Manuela
Pascarella, Rosario
Rizzi, Romana
Russo, Marco
Salomone, Gaetano
Romano, Antonio
Iaccarino, Corrado
Froio, Elisabetta
Serra, Silvia
Cozzi, Salvatore
Giaccherini, Lucia
Valzania, Franco
Pisanello, Anna
author_sort Ghezzi, Andrea
collection PubMed
description INTRODUCTION: Pituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor. METHODS: We present the case of a 58 years-old-man who reported a three-month history of polyuria-polydipsia syndrome, generalized asthenia, panhypopituitarism and bitemporal hemianopsia. Brain-MRI showed a voluminous pituitary mass causing posterior sellar enlargement and compression of the surrounding structures including pituitary stalk, optic chiasm, and optic nerves. RESULTS: The patient underwent neurosurgical removal of the mass. Histological examination revealed a poorly differentiated adenocarcinoma of uncertain origin. A total body CT scan showed a mass in the left kidney that was subsequently removed. Histological features were consistent with a clear cell carcinoma. However, endoscopic examination of the digestive tract revealed an ulcerating and infiltrating adenocarcinoma of the gastric cardia. Total body PET/CT scan with 18F-FDG confirmed an isolated area of accumulation in the gastric cardia, with no hyperaccumulation at other sites. CONCLUSION: To the best of our knowledge, there are no reports of pituitary metastases from gastric cardia adenocarcinoma. Our patient presented with symptoms of sellar involvement and without evidence of other body metastases. Therefore, sudden onset of diabetes insipidus and visual deterioration should lead to the suspicion of a rapidly growing pituitary mass, which may be the presenting manifestation of a primary extracranial adenocarcinoma. Histological investigation of the pituitary mass can guide the diagnostic workup, which must however be complete.
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spelling pubmed-98466272023-01-19 Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma Ghezzi, Andrea Rossi, Jessica Cavallieri, Francesco Napoli, Manuela Pascarella, Rosario Rizzi, Romana Russo, Marco Salomone, Gaetano Romano, Antonio Iaccarino, Corrado Froio, Elisabetta Serra, Silvia Cozzi, Salvatore Giaccherini, Lucia Valzania, Franco Pisanello, Anna Front Oncol Oncology INTRODUCTION: Pituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor. METHODS: We present the case of a 58 years-old-man who reported a three-month history of polyuria-polydipsia syndrome, generalized asthenia, panhypopituitarism and bitemporal hemianopsia. Brain-MRI showed a voluminous pituitary mass causing posterior sellar enlargement and compression of the surrounding structures including pituitary stalk, optic chiasm, and optic nerves. RESULTS: The patient underwent neurosurgical removal of the mass. Histological examination revealed a poorly differentiated adenocarcinoma of uncertain origin. A total body CT scan showed a mass in the left kidney that was subsequently removed. Histological features were consistent with a clear cell carcinoma. However, endoscopic examination of the digestive tract revealed an ulcerating and infiltrating adenocarcinoma of the gastric cardia. Total body PET/CT scan with 18F-FDG confirmed an isolated area of accumulation in the gastric cardia, with no hyperaccumulation at other sites. CONCLUSION: To the best of our knowledge, there are no reports of pituitary metastases from gastric cardia adenocarcinoma. Our patient presented with symptoms of sellar involvement and without evidence of other body metastases. Therefore, sudden onset of diabetes insipidus and visual deterioration should lead to the suspicion of a rapidly growing pituitary mass, which may be the presenting manifestation of a primary extracranial adenocarcinoma. Histological investigation of the pituitary mass can guide the diagnostic workup, which must however be complete. Frontiers Media S.A. 2023-01-04 /pmc/articles/PMC9846627/ /pubmed/36686817 http://dx.doi.org/10.3389/fonc.2022.1059361 Text en Copyright © 2023 Ghezzi, Rossi, Cavallieri, Napoli, Pascarella, Rizzi, Russo, Salomone, Romano, Iaccarino, Froio, Serra, Cozzi, Giaccherini, Valzania and Pisanello https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Ghezzi, Andrea
Rossi, Jessica
Cavallieri, Francesco
Napoli, Manuela
Pascarella, Rosario
Rizzi, Romana
Russo, Marco
Salomone, Gaetano
Romano, Antonio
Iaccarino, Corrado
Froio, Elisabetta
Serra, Silvia
Cozzi, Salvatore
Giaccherini, Lucia
Valzania, Franco
Pisanello, Anna
Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title_full Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title_fullStr Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title_full_unstemmed Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title_short Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
title_sort case report: pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846627/
https://www.ncbi.nlm.nih.gov/pubmed/36686817
http://dx.doi.org/10.3389/fonc.2022.1059361
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