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Pituitary Metastases Experience in a Neurosurgical Oncology Cohort

Received: 19 August 2022    Accepted: 4 October 2022    Published: 21 October 2022
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Abstract

Previously reported prevalence of pituitary metastases ranges from 0.4-5%. This study’s primary objective is to determine the incidence of pituitary metastases among patients presenting for neurosurgical evaluation with abnormal pituitary imaging findings, and secondarily to report our outcomes. We conducted a single-center, retrospective chart review of patients undergoing neurosurgical evaluation for sellar/suprasellar masses from 2008-2020. Demographic data, presenting symptoms, radiographic features, interventions, and outcomes were analyzed. 78 charts were reviewed; 21 patients (26.9%) had history of prior cancer, and 12 patients (15.4%) were diagnosed with pituitary metastases using pathologic and/or MRI criteria. Of the 21 patients with prior cancer diagnosis, 52.4% were diagnosed with pituitary metastases: 28.6% using MRI criteria and 23.8% using pathologic criteria. Average age of patients with metastases was 61.8 years. Tumor pathology consisted of 33.3% breast, 33.3% lung, 8.3% esophageal, 8.3% renal, 8.3% neuroendocrine and 8.3% melanoma. Pituitary metastasis diagnosis led to one patient’s initial cancer diagnosis. Symptoms at diagnosis included 33.3% headaches, 41.7% endocrinopathies, and 25% visual deficits. Treatment included surgical intervention plus radiation in 41.7%, surgery alone in 8.3%, radiation alone in 25%, and observation alone in 25%. Median follow-up, progression-free-survival, and overall survival was 8.8 months, 4.5 months, and 11.5 months, respectively. Incidence of pituitary metastases in our cohort is higher than previously reported in the general population. Given these findings, there may be a role for early excisional biopsy or resection of sellar/suprasellar lesions in cancer patients, as confirmation of CNS metastatic disease may require targeted brain radiation and/or alteration of systemic therapy.

Published in International Journal of Neurosurgery (Volume 6, Issue 2)
DOI 10.11648/j.ijn.20220602.19
Page(s) 84-89
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pituitary Metastases, Cancer Patients, Clinical Outcomes

References
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  • APA Style

    Sebastian Rubino, Katherine Kunigelis, John Lynes, Solmaz Sahebjam, Krupal Patel, et al. (2022). Pituitary Metastases Experience in a Neurosurgical Oncology Cohort. International Journal of Neurosurgery, 6(2), 84-89. https://doi.org/10.11648/j.ijn.20220602.19

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    ACS Style

    Sebastian Rubino; Katherine Kunigelis; John Lynes; Solmaz Sahebjam; Krupal Patel, et al. Pituitary Metastases Experience in a Neurosurgical Oncology Cohort. Int. J. Neurosurg. 2022, 6(2), 84-89. doi: 10.11648/j.ijn.20220602.19

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    AMA Style

    Sebastian Rubino, Katherine Kunigelis, John Lynes, Solmaz Sahebjam, Krupal Patel, et al. Pituitary Metastases Experience in a Neurosurgical Oncology Cohort. Int J Neurosurg. 2022;6(2):84-89. doi: 10.11648/j.ijn.20220602.19

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  • @article{10.11648/j.ijn.20220602.19,
      author = {Sebastian Rubino and Katherine Kunigelis and John Lynes and Solmaz Sahebjam and Krupal Patel and Andre Beer-Furlan and James Liu and Michael Vogelbaum and Arnold Etame and John Arrington and Nam Tran},
      title = {Pituitary Metastases Experience in a Neurosurgical Oncology Cohort},
      journal = {International Journal of Neurosurgery},
      volume = {6},
      number = {2},
      pages = {84-89},
      doi = {10.11648/j.ijn.20220602.19},
      url = {https://doi.org/10.11648/j.ijn.20220602.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.19},
      abstract = {Previously reported prevalence of pituitary metastases ranges from 0.4-5%. This study’s primary objective is to determine the incidence of pituitary metastases among patients presenting for neurosurgical evaluation with abnormal pituitary imaging findings, and secondarily to report our outcomes. We conducted a single-center, retrospective chart review of patients undergoing neurosurgical evaluation for sellar/suprasellar masses from 2008-2020. Demographic data, presenting symptoms, radiographic features, interventions, and outcomes were analyzed. 78 charts were reviewed; 21 patients (26.9%) had history of prior cancer, and 12 patients (15.4%) were diagnosed with pituitary metastases using pathologic and/or MRI criteria. Of the 21 patients with prior cancer diagnosis, 52.4% were diagnosed with pituitary metastases: 28.6% using MRI criteria and 23.8% using pathologic criteria. Average age of patients with metastases was 61.8 years. Tumor pathology consisted of 33.3% breast, 33.3% lung, 8.3% esophageal, 8.3% renal, 8.3% neuroendocrine and 8.3% melanoma. Pituitary metastasis diagnosis led to one patient’s initial cancer diagnosis. Symptoms at diagnosis included 33.3% headaches, 41.7% endocrinopathies, and 25% visual deficits. Treatment included surgical intervention plus radiation in 41.7%, surgery alone in 8.3%, radiation alone in 25%, and observation alone in 25%. Median follow-up, progression-free-survival, and overall survival was 8.8 months, 4.5 months, and 11.5 months, respectively. Incidence of pituitary metastases in our cohort is higher than previously reported in the general population. Given these findings, there may be a role for early excisional biopsy or resection of sellar/suprasellar lesions in cancer patients, as confirmation of CNS metastatic disease may require targeted brain radiation and/or alteration of systemic therapy.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Pituitary Metastases Experience in a Neurosurgical Oncology Cohort
    AU  - Sebastian Rubino
    AU  - Katherine Kunigelis
    AU  - John Lynes
    AU  - Solmaz Sahebjam
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    AU  - Andre Beer-Furlan
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    AU  - Michael Vogelbaum
    AU  - Arnold Etame
    AU  - John Arrington
    AU  - Nam Tran
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    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
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    EP  - 89
    PB  - Science Publishing Group
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    AB  - Previously reported prevalence of pituitary metastases ranges from 0.4-5%. This study’s primary objective is to determine the incidence of pituitary metastases among patients presenting for neurosurgical evaluation with abnormal pituitary imaging findings, and secondarily to report our outcomes. We conducted a single-center, retrospective chart review of patients undergoing neurosurgical evaluation for sellar/suprasellar masses from 2008-2020. Demographic data, presenting symptoms, radiographic features, interventions, and outcomes were analyzed. 78 charts were reviewed; 21 patients (26.9%) had history of prior cancer, and 12 patients (15.4%) were diagnosed with pituitary metastases using pathologic and/or MRI criteria. Of the 21 patients with prior cancer diagnosis, 52.4% were diagnosed with pituitary metastases: 28.6% using MRI criteria and 23.8% using pathologic criteria. Average age of patients with metastases was 61.8 years. Tumor pathology consisted of 33.3% breast, 33.3% lung, 8.3% esophageal, 8.3% renal, 8.3% neuroendocrine and 8.3% melanoma. Pituitary metastasis diagnosis led to one patient’s initial cancer diagnosis. Symptoms at diagnosis included 33.3% headaches, 41.7% endocrinopathies, and 25% visual deficits. Treatment included surgical intervention plus radiation in 41.7%, surgery alone in 8.3%, radiation alone in 25%, and observation alone in 25%. Median follow-up, progression-free-survival, and overall survival was 8.8 months, 4.5 months, and 11.5 months, respectively. Incidence of pituitary metastases in our cohort is higher than previously reported in the general population. Given these findings, there may be a role for early excisional biopsy or resection of sellar/suprasellar lesions in cancer patients, as confirmation of CNS metastatic disease may require targeted brain radiation and/or alteration of systemic therapy.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Head and Neck–Endocrine Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Radiology, Moffitt Cancer Center and Research Institute, Tampa, United States

  • Department of Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, United States

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