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 language | English |
|---|---|
| Pages (from-to) | 93-102 |
| Number of pages | 10 |
| Journal | Pituitary |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Mar 2008 |
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Keywords
- Lu-DOTATATE
- Y-DOTATOC
- Neuroendocrine tumours
- Octreotide
- Pituitary mass
ASJC Scopus subject areas
- Endocrinology
Cite this
Treatment of a pituitary metastasis from a neuroendocrine tumour : Case report and literature review. / Goglia, Umberto; Ferone, Diego; Sidoti, Marilena; Spaziante, Renato; Dadati, Patrizia; Ravetti, Jean Luis; Villa, Giuseppe; Bodei, Lisa; Paganelli, Giovanni; Minuto, Francesco; Giusti, Massimo.
In: Pituitary, Vol. 11, No. 1, 03.2008, p. 93-102.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of a pituitary metastasis from a neuroendocrine tumour
T2 - Case report and literature review
AU - Goglia, Umberto
AU - Ferone, Diego
AU - Sidoti, Marilena
AU - Spaziante, Renato
AU - Dadati, Patrizia
AU - Ravetti, Jean Luis
AU - Villa, Giuseppe
AU - Bodei, Lisa
AU - Paganelli, Giovanni
AU - Minuto, Francesco
AU - Giusti, Massimo
PY - 2008/3
Y1 - 2008/3
N2 - 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.
AB - 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.
KW - Lu-DOTATATE
KW - Y-DOTATOC
KW - Neuroendocrine tumours
KW - Octreotide
KW - Pituitary mass
UR - http://www.scopus.com/inward/record.url?scp=38649104477&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38649104477&partnerID=8YFLogxK
U2 - 10.1007/s11102-007-0038-6
DO - 10.1007/s11102-007-0038-6
M3 - Article
VL - 11
SP - 93
EP - 102
JO - Pituitary
JF - Pituitary
SN - 1386-341X
IS - 1
ER -