UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
未经授权:我们介绍了一个58岁的男性,他报告了三个月的多尿多饮综合征病史,全身乏力,全垂体功能减退症和双颞侧偏盲。脑MRI显示大量垂体肿块,导致鞍后增大和周围结构(包括垂体柄)受压,视神经交叉,和视神经.
未经证实:患者接受了神经外科手术切除肿块。组织学检查显示来源不确定的低分化腺癌。全身CT扫描显示左肾肿块随后被切除。组织学特征与透明细胞癌一致。然而,消化道内镜检查显示胃card门的溃疡和浸润性腺癌。用18F-FDG进行的全身PET/CT扫描证实胃card门中有一个孤立的积聚区域,在其他地点没有过度积累。
未经授权:据我们所知,没有胃贲门腺癌发生垂体转移的报道.我们的患者出现鞍区受累的症状,并且没有其他身体转移的证据。因此,尿崩症的突然发作和视力恶化应导致怀疑迅速增长的垂体肿块,这可能是原发性颅外腺癌的表现。垂体肿块的组织学研究可以指导诊断检查,然而,它必须是完整的。