E-ISSN: 1019-5157
ISSN: 2651-5024
Case Report
Pituitary Metastasis of Cervical Squamous Cell Carcinoma
Esra Eraslan Aydemir✉ ,
Mine Araz ,
Duygu Enneli ,
Aylin Okçu Heper ,
Mustafa Şahin
DOI: 10.5137/1019-5149.JTN.50528-25.2
Article in Press
Corresponding Author:
Esra Eraslan Aydemir (esraeraslan91@gmail.com)
Abstract
Abstract
Objective: Pituitary metastases are rare, constituting only 1-2% of sellar masses. While various malignancies can metastasize to the pituitary gland, cervical cancer with isolated pituitary involvement is exceptionally uncommon. Literature review reveals only four previously reported cases of symptomatic pituitary metastasis from cervical carcinoma. We present a rare case of isolated pituitary metastasis from cervical squamous cell carcinoma presenting with diabetes insipidus and visual field defects.
Case: A 52-year-old woman presented 13 months after treatment for stage IB non-keratinizing squamous cell carcinoma of the cervix with severe headache, visual loss, polyuria (6 L/day), and polydipsia. Cranial MRI revealed a 2×2×1.5 cm sellar-suprasellar mass. Laboratory evaluation confirmed diabetes insipidus and anterior pituitary insufficiency, and visual field examination showed bitemporal hemianopsia. The mass was excised via transnasal transsphenoidal approach. Histopathological and immunohistochemical analysis confirmed metastatic squamous cell carcinoma consistent with the primary cervical tumor. Postoperative PET imaging showed no additional metastatic foci. Despite radiotherapy and hormone replacement therapy, the patient died of massive pulmonary embolism six months after pituitary surgery.
Conclusion: This represents one of the few symptomatic cases of cervical cancer pituitary metastasis diagnosed during life and the first reported squamous cell carcinoma histology with isolated pituitary metastasis. Clinicians should maintain high suspicion for pituitary involvement in cervical cancer survivors presenting with diabetes insipidus and visual field defects, regardless of disease-free interval. Early recognition and timely intervention are crucial, as prompt diagnosis may improve patient outcomes and potentially be life-saving.
Objective: Pituitary metastases are rare, constituting only 1-2% of sellar masses. While various malignancies can metastasize to the pituitary gland, cervical cancer with isolated pituitary involvement is exceptionally uncommon. Literature review reveals only four previously reported cases of symptomatic pituitary metastasis from cervical carcinoma. We present a rare case of isolated pituitary metastasis from cervical squamous cell carcinoma presenting with diabetes insipidus and visual field defects.
Case: A 52-year-old woman presented 13 months after treatment for stage IB non-keratinizing squamous cell carcinoma of the cervix with severe headache, visual loss, polyuria (6 L/day), and polydipsia. Cranial MRI revealed a 2×2×1.5 cm sellar-suprasellar mass. Laboratory evaluation confirmed diabetes insipidus and anterior pituitary insufficiency, and visual field examination showed bitemporal hemianopsia. The mass was excised via transnasal transsphenoidal approach. Histopathological and immunohistochemical analysis confirmed metastatic squamous cell carcinoma consistent with the primary cervical tumor. Postoperative PET imaging showed no additional metastatic foci. Despite radiotherapy and hormone replacement therapy, the patient died of massive pulmonary embolism six months after pituitary surgery.
Conclusion: This represents one of the few symptomatic cases of cervical cancer pituitary metastasis diagnosed during life and the first reported squamous cell carcinoma histology with isolated pituitary metastasis. Clinicians should maintain high suspicion for pituitary involvement in cervical cancer survivors presenting with diabetes insipidus and visual field defects, regardless of disease-free interval. Early recognition and timely intervention are crucial, as prompt diagnosis may improve patient outcomes and potentially be life-saving.
Keywords
Key words: cervical cancer
pituitary metastasis
diabetes insipidus
sellar mass