Treatment of a pituitary metastasis from a neuroendocrine tumour: Case report and literature review

Umberto Goglia, Diego Ferone, Marilena Sidoti, Renato Spaziante, Patrizia Dadati, Jean Luis Ravetti, Giuseppe Villa, Lisa Bodei, Giovanni Paganelli, Francesco Minuto, Massimo Giusti

Research output: Contribution to journalArticle

Abstract

Herein we report a rare case of a pituitary metastasis from a neuroendocrine tumour mimicking an adenoma. Moreover, starting from this unusual case, the relevant literature concerning the diagnosis and management of patients with metastasis at pituitary level is reviewed. A 69-year-old woman was admitted to our Unit for severe headache, diplopia, and critical visual field impairment. MRI showed a large pituitary mass compressing the optic chiasm and infiltrating the cavernous sinus. Trans-sphenoidal biopsy revealed a pituitary metastasis from a neuroendocrine tumour, in line with the multiple liver lesions that were already considered metastases from an ileal primary neuroendocrine tumour. In vitro receptor characterisation of both pituitary and liver tissues by immunohistochemistry showed a heterogeneous somatostatin receptor subtype pattern, with a predominant expression of sst2 within the pituitary lesion. However, the liver metastasis receptor profile was completely different from the pituitary. Octreotide LAR was administered first, followed by receptor radiometabolic therapy with radiolabelled somatostatin analogues (90Y-DOTATOC and 177Lu-DOTATATE). After 16 months, MRI showed a significant shrinkage of the sellar mass. Moreover, disappearance of diplopia and visual defects, together with a considerable improvement in quality of life were gradually recorded. To our knowledge, this is the first case of combined treatment using 'cold' and radiolabelled octreotide in a pituitary metastasis from a neuroendocrine tumour.

Original languageEnglish
Pages (from-to)93-102
Number of pages10
JournalPituitary
Volume11
Issue number1
DOIs
Publication statusPublished - Mar 2008

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Keywords

  • Lu-DOTATATE
  • Y-DOTATOC
  • Neuroendocrine tumours
  • Octreotide
  • Pituitary mass

ASJC Scopus subject areas

  • Endocrinology

Cite this

Goglia, U., Ferone, D., Sidoti, M., Spaziante, R., Dadati, P., Ravetti, J. L., Villa, G., Bodei, L., Paganelli, G., Minuto, F., & Giusti, M. (2008). Treatment of a pituitary metastasis from a neuroendocrine tumour: Case report and literature review. Pituitary, 11(1), 93-102. https://doi.org/10.1007/s11102-007-0038-6