Journal of Neuro-Oncology

, Volume 126, Issue 2, pp 219–224 | Cite as

Pituitary metastasis: is there still a place for neurosurgical treatment?

  • V. Gilard
  • C. Alexandru
  • F. Proust
  • S. Derrey
  • P. Hannequin
  • O. Langlois
Topic Review


Pituitary metastases are uncommon, ranging from 1 to 5 % of all metastases. Between 10 and 30 % of pituitary lesions are symptomatic responsible for diabetes insipidus, visual field defect or cranial nerve palsy. Primary sites are lung or breast in two-thirds of cases. There is no current reference concerning treatment of such lesions. Overall survival is poor and depends on primary site. Although the role of surgery is currently limited, discussion is warranted in several indications for diagnostic or symptomatic purposes. We report two cases of symptomatic pituitary metastases in a context of breast cancer and review the litterature concerning the role of surgery and other treatment modalities.


Pituitary gland- metastases Surgical treatment 



The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.

Compliance with ethical standards

Conflict of interest



  1. 1.
    Tomita H, Urui S, Kokunai T, Tamaki N (2000) A case of metastatic tumor of the pituitary gland presenting as a subarachnoid hemorrhage. No Shinkei Geka 28:1117–1120PubMedGoogle Scholar
  2. 2.
    Kim YH, Lee B, Lee KJ, Cho JH (2012) A case of pituitary metastasis from breast cancer that presented as left visual disturbance. J Korean Neurosurg Soc 51:94–97PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Fassett DR, Couldwell WT (2004) Metastases to the pituitary gland. Neurosurg Focus 16:1–4Google Scholar
  4. 4.
    Morita A, Meyer FB, Laws ERJ (1998) Symptomatic pituitary metastases. J Neurosurg 89:69–73PubMedCrossRefGoogle Scholar
  5. 5.
    Zoli M, Mazzatenta D, Faustini-Fustini M, Pasquini E, Frank G (2013) Pituitary metastases: role of surgery. World Neurosurg 79:327–330PubMedCrossRefGoogle Scholar
  6. 6.
    He W, Chen F, Dalm B, Kirby PA, Greenlee JDW (2015) Metastatic involvement of the pituitary gland: a systematic review with pooled individual patient data analysis. Pituitary 18:159–168PubMedCrossRefGoogle Scholar
  7. 7.
    Teears RJ, Silverman EM (1975) Clinicopathologic review of 88 cases of carcinoma metastatic to the putuitary gland. Cancer 36:216–220PubMedCrossRefGoogle Scholar
  8. 8.
    Kam J, Kam J, Mann GB, Phillips C, Wentworth JM, King J, Linderman GJ (2015) Solitary pituitary metastasis from HER2-positive breast cancer: Pituitary metastasis in HER2+ breast cancer. Asia Pac J Clin Oncol. doi: 10.1111/ajco.12353 PubMedGoogle Scholar
  9. 9.
    Fortunati N, Felicetti F, Donadio M, Grossi E, Michelon F, Ritorto G, Arvat E, Brignardello E (2015) Pituitary lesions in breast cancer patients: a report of three cases. Oncol Lett 9:2762–2766PubMedPubMedCentralGoogle Scholar
  10. 10.
    Komninos J, Vlassopoulou V, Protopapa D, Korfias S, Kontogeorgos G, Sakas DE et al (2004) Tumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab 89:574–580PubMedCrossRefGoogle Scholar
  11. 11.
    Feiz-Erfan I, Rao G, White W, McCutcheon I (2008) Efficacy of trans-septal trans-sphenoidal surgery in correcting visual symptoms caused by hematogenous metastases to the sella and pituitary gland. Skull Base 18:77–84PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Spinelli GP, Russo GL, Miele E, Prinzi N, Tomao F, Antonelli M, Giangaspero F, Stati V, Strudel M, Tomao S (2012) Breast cancer metastatic to the pituitary gland: a case report. World J Surg Oncol. doi: 10.1186/1477-7819-10-137 Google Scholar
  13. 13.
    Eksi MS, Hasanov T, Yilmaz B, Akakin A, Bayri Y, Bozkurt SU et al (2014) Isolated metastasis of breast cancer to the pituitary gland. Neurol India 62:70–71PubMedCrossRefGoogle Scholar
  14. 14.
    Marin F, Kovacs KT, Scheithauer BW, Young WFJ (1992) The pituitary gland in patients with breast carcinoma: a histologic and immunocytochemical study of 125 cases. Mayo Clin Proc 67:949–956PubMedCrossRefGoogle Scholar
  15. 15.
    Gurling KJ, Scott GBD, Baron DN (1957) Metastases in pituitary tissue removed at hypophysectomy in women with mammary carcinoma. Br J Cancer 11:519PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Burkhardt T, Henze M, Kluth LA, Westphal M, Schmidt NO, Flitsch J (2015) Surgical management of pituitary metastases. Pituitary. doi: 10.1007/s11102-015-0676-z
  17. 17.
    Max MB, Deck MD, Rottenberg DA (1981) Pituitary metastasis: incidence in cancer patients and clinical differentiation from pituitary adenoma. Neurology 31:998PubMedCrossRefGoogle Scholar
  18. 18.
    Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford LD (2009) Stereotactic radiosurgery for pituitary metastases. Surg Neurol 72:248–255PubMedCrossRefGoogle Scholar
  19. 19.
    Hagerstrand I, Schonebeck J (1969) Metastases to the pituitary gland. Acta Pathol Microbiol Scand 75:1–4Google Scholar
  20. 20.
    Mori Y, Kobayashi T, Shibamoto Y (2006) Stereotactic radiosurgery for metastatic tumors in the pituitary gland and the cavernous sinus. J Neurosurg 105:37–42PubMedGoogle Scholar
  21. 21.
    Roessmann U, Kaufman B, Friede RL (1970) Metastatic lesions in the sella turcica and pituitary gland. Cancer 25:478–480PubMedCrossRefGoogle Scholar
  22. 22.
    Ratti M, Passalacqua R, Poli R, Betri E, Crispino M, Poli R et al (2013) Pituitary gland metastasis from rectal cancer: report of a case and literature review. SpringerPlus 2:467PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Abrams HL, Spiro R, Goldstein N (1950) Metastases in carcinoma. Analysis of 1000 autopsied cases. Cancer 3:74–85PubMedCrossRefGoogle Scholar
  24. 24.
    Houck WA, Olson KB, Horton J (1970) Clinical features of tumor metastasis to the pituitary. Cancer 26:656–659PubMedCrossRefGoogle Scholar
  25. 25.
    Grisoli F, Leclercq TA, Robert F, Hardy J (1974) Pituitary metastases of breast cancer. Neurochirurgie 20:583–592PubMedGoogle Scholar
  26. 26.
    Turaka A, Parsons RB, Buyyounouski MK (2012) Radiation therapy for pituitary metastasis: report of four cases. Tumori 98:e1–e6PubMedGoogle Scholar
  27. 27.
    Hermet M, Delévaux I, Trouillier S, André M, Chazal J, Aumaître O (2009) Diabète insipide révélateur de métastases hypophysaires: quatre observations et revue de la littérature. Rev Médecine Interne 30:425–429CrossRefGoogle Scholar
  28. 28.
    Lau G, Tan SY, Chiang G, Poh WT (1998) Bronchioloalveolar carcinoma with metastasis to the pituitary gland: a case report. J Clin Pathol 51:931–934PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Aaberg TMJ, Kay M, Sternau L (1995) Metastatic tumors to the pituitary. Am J Ophthalmol 119:779–785PubMedCrossRefGoogle Scholar
  30. 30.
    Couldwell WT, Chandrasoma PT, Weiss MH (1989) Pituitary gland metastasis from adenocarcinoma of the prostate. Case report. J Neurosurg 71:138–140PubMedCrossRefGoogle Scholar
  31. 31.
    Johnston PC, Black NR, McIlroy J, Sharkey R, Garvey A, Lindsay JR (2013) Hypopituitarism as the presenting feature of bronchogenic carcinoma with metastases to the pituitary gland. Indian J Endocrinol Metab 17:167–169PubMedPubMedCentralGoogle Scholar
  32. 32.
    Altay T, Krisht KM, Couldwell WT (2012) Sellar and parasellar metastatic tumors. Int J Surg Oncol 2012:1–9CrossRefGoogle Scholar
  33. 33.
    Sagoh M, Kodaki K, Ichikizaki K, Murakami K, Oizumi T, Kawase T et al (1996) Skull base metastasis from renal cell carcinoma presenting as abducens nerve paresis: report of two cases. No Shinkei Geka 24:829–833PubMedGoogle Scholar
  34. 34.
    Shrieve DC, Hazard L, Boucher K, Jensen RL (2004) Dose fractionation in stereotactic radiotherapy for parasellar meningiomas: radiobiological considerations of efficacy and optic nerve tolerance. J Neurosurg 101(Suppl 3):390–395PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of NeurosurgeryRouen University HospitalRouen CedexFrance
  2. 2.Department of OncologyHenri Becquerel Cancer CenterRouenFrance
  3. 3.Department of NeurosurgeryStrasbourg University HospitalStrasbourgFrance

Personalised recommendations