Highlights
- •Comprehensive review of metastatic lesions to the pituitary.
- •Includes review of tumor-tumor metastasis and metastatic collision tumors.
- •Radiological insights to primary versus pituitary metastatic lesions.
- •Management of pituitary metastasis including surgical indications and adjuvant therapy.
Abstract
Purpose
A review of the literature with respect to pituitary metastases (PM) with clinical
and radiological considerations are summarized to facilitate clinical decision making
in the management of PM
Methods
A review of literature associated with PM and tumour to tumour metastases in the English
literature was reviewed and summarized
Results
Pituitary metastases account for 1.0–3.6% of all surgically treated pituitary lesions. Often identified in parallel with extensive disseminated disease, once diagnosed,
the prognosis is generally poor, although survival is highly heterogeneous and dependent
on the primary tumor histology. Within this anatomical region is also the observation
of tumor-to-tumor metastases and collision tumours. Both the tumor macro- and microenvironment
play central roles to the progression of disease with distinctive radiological features
that may suggest a metastatic sellar lesion as opposed to a primary pituitary lesion.
Surgical resection is the first line of therapy followed by adjuvant chemoradiotherapy
and endocrinological evaluation for hormonal supplementation
Conclusion
PMs are relatively rare but important oncological entities representing disseminated
disease in the majority of cases. Careful consideration of the relevant clinical history
and radiological features can aid the clinician differentiate between a metastatic
lesion to the pituitary region and a primary pituitary tumor. While surgical resection
is first line therapy, stereotactic radiosurgery in carefully selected patients is
emerging as a viable alternative.
Keywords
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Article info
Publication history
Accepted:
September 7,
2021
Received:
April 29,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
