Metastases to the Pituitary Gland

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

Disclosures

May 18, 2004

Location of Metastases Within the Pituitary

Authors of early series have reported that the majority of pituitary metastases occur in the posterior pituitary, but some dispute this claim. In a series of 88 cases of carcinoma that had metastasized to the pituitary, Teears and Sliverman[25] reported that 57% of the lesions localized to the posterior pituitary alone, 13% to the anterior pituitary alone, 12% to both lobes, and the remaining to the capsule or stalk. These authors hypothesized that the posterior pituitary, by receiving a direct arterial blood supply, is more likely to develop metastases than the adenohypophysis, which receives its blood supply from the hypophysial portal system.

Some authors have suggested that certain malignant diseases such as breast cancer may have an increased affinity for the adenohypophysis because of a nascent hormonal attraction. Two series limited to pituitary metastases from breast carcinoma have shown a preponderance of anterior pituitary involvement, with 70 and 82% rates of anterior pituitary involvement, respectively.[8,18] The reported metastatic involvement of the neurohypophysis and adenohypophysis is summarized in Table 2 ; there is a trend toward increased rates of anterior pituitary involvement associated with breast cancer.

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