Abstract:
BACKGROUND:Pituitary metastasis is a rare condition with a poor prognosis. Very few patients with pituitary metastasis are symptomatic. It is often associated with presence of co-existing metastases to other organs. Isolated pituitary metastasis as the first presentation of primary malignancy is uncommon. CASE PRESENTATION:A 72-year-old woman presented with a 2-month history of polyuria, increasing thirst and unexplained weight loss. Esophagogastroduodenoscopy (EGD) was scheduled as part of the investigation. She was kept nil per os for 10 h prior to EGD, after which she developed alteration of consciousness. Further investigation revealed hypernatremia with sodium level of 161 mmol/L and low urine osmolality of 62 mOsm/kg. Her urine output was 300 mL per hour. Diabetes insipidus (DI) was diagnosed based on evidence of polyuria, hypernatremia, and low urine osmolality. Her urine output decreased and urine osmolality increased to 570 mOsm/kg in response to subcutaneous desmopressin acetate, confirming central DI. Pituitary magnetic resonance imaging showed a heterogeneous gadolinium enhancing lesion at the sellar and suprasellar regions, measuring 2.4 × 2.6 × 3.9 cm compressing both the hypothalamus bilaterally and the inferior aspect of optic chiasm as well as displacing the residual pituitary gland anteriorly. The posterior pituitary bright spot was absent. These MRI findings suggested pituitary macroadenoma. There were also multiple small gadolinium-enhancing lesions up to 0.7 cm in size with adjacent vasogenic brain edema at the subcortical and subpial regions of the left frontal and parietal areas, raising the concern of brain metastases. Pituitary hormonal evaluation was consistent with panhypopituitarism. Histopathological and immunohistochemical studies of the pituitary tissue revealed an adenocarcinoma, originating from the lung. Computed tomography of the chest and abdomen was subsequently performed, showing a 2.2-cm soft tissue mass at the proximal part of right bronchus. There was no evidence of distant metastases elsewhere. The final diagnosis was adenocarcinoma of the lung with pituitary metastasis manifesting as panhypopituitarism and central DI. Palliative care along with hormonal replacement therapy was offered to the patient. She died 4 months after diagnosis. CONCLUSION:Diagnosis of pituitary metastasis is challenging, especially in patients with previously undiagnosed primary cancer. It should be considered in the elderly patients presenting with new-onset central DI with or without anterior pituitary dysfunction.
journal_name
BMC Endocr Disordjournal_title
BMC endocrine disordersauthors
Sirinvaravong S,Vibhatavata P,Chunharojrith P,Cheunsuchon P,Sriussadaporn Sdoi
10.1186/s12902-019-0445-5subject
Has Abstractpub_date
2019-10-29 00:00:00pages
114issue
1issn
1472-6823pii
10.1186/s12902-019-0445-5journal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:Previous studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00612-6
更新日期:2020-09-05 00:00:00
abstract:BACKGROUND:Pituitary disorders following pregnancy are an important yet under reported clinical entity in the developing world. Conversely, post partum panhypopituitarism has a more devastating impact on women in such settings due to high fertility rates, poor obstetric care and scarcity of diagnostic and therapeutic r...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-12-4
更新日期:2012-07-10 00:00:00
abstract:BACKGROUND:The nonthyroidal illness syndrome (NTIS) is prevalent among patients with enterocutaneous fistula and is associated with poor outcomes. The present study aimed to explore the role of enteral nutrition (EN) therapy on thyroid function among patients with enterocutaneous fistula and NTIS. METHODS:We conducted...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-015-0061-y
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abstract:BACKGROUND:Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. MET...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00623-3
更新日期:2020-09-17 00:00:00
abstract:BACKGROUND:Vitamin D deficiency is pandemic while resources available to measure 25-hydroxyvitamin D (25OHD) are limited. The present study aimed to verify whether sun exposure measured by a structured questionnaire could predict serum 25OHD concentrations in healthy Caucasian individuals living in a tropical area. ME...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-018-0272-0
更新日期:2018-07-03 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-13-36
更新日期:2013-09-29 00:00:00
abstract:BACKGROUND:Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle mod...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0434-8
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:Diabetes self-management education can be helpful for patients with type 2 diabetes in managing their condition. We aimed to study the effects of the group-based PRoactive Interdisciplinary Self-MAnagement (PRISMA) training program on self-reported and clinical outcomes in patients with type 2 diabetes treat...
journal_title:BMC endocrine disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12902-019-0466-0
更新日期:2019-12-11 00:00:00
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pub_type: 杂志文章
doi:10.1186/1472-6823-14-92
更新日期:2014-12-01 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00554-z
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-015-0026-1
更新日期:2015-06-18 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-7-2
更新日期:2007-04-02 00:00:00
abstract:BACKGROUND:Type 2 diabetes is a common and costly illness, associated with significant morbidity and mortality. Despite this, there is relatively little information on the 'real-world' medication utilization patterns for patients with type 2 diabetes initiating exenatide BID or glargine. The objective of this study was...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-13-20
更新日期:2013-06-22 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0370-7
更新日期:2019-05-07 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-9-8
更新日期:2009-02-25 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12902-020-00628-y
更新日期:2020-09-29 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-016-0107-9
更新日期:2016-05-23 00:00:00
abstract:BACKGROUND:We quantified, among diabetic adults, the frequency, costs, and factors associated with visits to the emergency department (EDs) and subsequent hospitalizations for acute hypoglycaemic and hyperglycaemic events. METHODS:We included adults with diabetes residing in the Milan Agency for Health Protection betw...
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pub_type: 杂志文章
doi:10.1186/s12902-020-0546-1
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-8-3
更新日期:2008-03-27 00:00:00
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更新日期:2020-12-09 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
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更新日期:2014-03-03 00:00:00
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journal_title:BMC endocrine disorders
pub_type: 杂志文章
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更新日期:2012-12-13 00:00:00
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更新日期:2018-05-29 00:00:00