Metastases to the Pituitary Gland

Daniel R. Fassett, M.D.; William T. Couldwell, M.D., PhD

Disclosures

May 18, 2004

Prevalence of Pituitary Metastases

Authors of reports on large autopsy series have stated that pituitary metastases occur in between 1 and 3.6% of patients with malignant tumors.[1,15,19] If one considers autopsy series in which both the pituitary and surrounding sella turcica have been evaluated, however, rates of metastasis as high as 27% have been reported to occur in this area.[24] Breast cancer is the most common tumor to metastasize to the pituitary gland; its frequency is followed by that of lung cancer. Prostate,[6,17] renal cell,[14,26] and gastrointestinal cancers,[11] and lymphoma,[16] leukemia, thyroid carcinoma,[2,5] and plasmocytoma[3,10] have also been reported ( Table 1 ).[7] Despite the association with breast cancer, there does not appear to be any significant sex predominance with pituitary metastases.[15,22,25]

Breast and lung cancer are the two most common forms of malignant tumors, which partially accounts for the high proportion of pituitary metastases from these two types of cancer. In specifically looking at breast cancer, there appears to be an increased rate of pituitary metastases with this malignant tumor. Histological examinations of pituitary glands obtained during hypophysectomy for palliation in end-stage breast cancer and from autopsy series have documented pituitary metastases in 6 to 29% of breast cancer patients.[1,8,9,18,24] Some authors theorize that the hormonal environment of the pituitary gland may attract breast cancer cells and provide an optimal environment for these malignant cells to thrive, accounting for the higher prevalence of pituitary metastases associated with this disease.

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