Pituitary metastasis from medullary carcinoma of thyroid: case report and review of literature

  • Harjinder S. BhatoeEmail author
  • Sonia Badwal
  • Vibha Dutta
  • N. Kannan
Clinical-patient studies


Pituitary is a rare site for metastases from thyroid cancer. Most reported cases have been of papillary and follicular carcinoma. Metastases from medullary thyroid carcinoma have not been reported. We report a case of intrapituitary metastasis from medullary carcinoma thyroid in a 38-year-old male, who had been operated for pituitary adenoma 5 years earlier. At the time of presentation in Nov 2006, he had visual field defects and a painless thyroid nodule. Further evaluation revealed medullary carcinoma thyroid, cervical and mediastinal lymphadenopathy, elevated serum calcitonin levels, and lobulated pituitary tumor. After surgical excision of thyroid and lymph node clearance, he underwent craniotomy and subfrontal excision of pituitary tumor. All the tumors were of identical histology, i.e., medullary carcinoma thyroid. Pituitary tumor was positive for calcitonin.


Brain tumor Brain metastases Calcitonin Thyroid carcinoma Medullary carcinoma Pituitary tumor 


  1. 1.
    Abrams HL, Spiro R, Goldstein N (1950) Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 3:74–85PubMedCrossRefGoogle Scholar
  2. 2.
    Kovacs K (1973) Metastatic cancer of the pituitary gland. Oncology 27:533–542PubMedGoogle Scholar
  3. 3.
    Max MB, Kovacs KT, Scheithauer BW et al (1992) The pituitary gland in patients with breast carcinoma: a histologic and immunocytochemical study of 125 cases. Mayo Clin Proc 67:949–956Google Scholar
  4. 4.
    Fassett DR, Couldwell WT (2004) Metastases to the pituitary gland. Neurosurgical Focus 16(4) Article 8. Accessed on 04 May 2007Google Scholar
  5. 5.
    Teears RJ, Silverman EM (1975) Clinicopathologic review of 88 cases of carcinoma metastatic to the pituitary gland. Cancer 36:216–220PubMedCrossRefGoogle Scholar
  6. 6.
    Marin F, Kovacs KT, Scheithauer BW et al (1992) The pituitary gland in patients with breast carcinoma: a histologic and immunocytochemical study of 125 cases. Mayo Clin Proc 67:949–956PubMedGoogle Scholar
  7. 7.
    Morita A, Meyers FB, Laws ER Jr (1998) Symptomatic pituitary metastases. J Neurosurg 89:69–73PubMedGoogle Scholar
  8. 8.
    Weilbaecher C, Patwardhan RV, Fowler M, Willis BK, Nanda A (2004) Metastatic lesions involving the sella: report of three cases and review of literature. Neurology India 52:365–368PubMedGoogle Scholar
  9. 9.
    Brand CL Jr, Laws ER Jr (1987) Metastatic tumors of the sella turcica masquerading as primary pituitary tumors. J Clin Endocrinol Metab 65:469–474Google Scholar
  10. 10.
    Bell CD, Kovacs K, Horvath F, Smythe H, Asa S (2001) Papillary carcinoma of thyroid metastatic to the pituitary gland. Arch Pathol Lab Med 125:935–938PubMedGoogle Scholar
  11. 11.
    Chrisoulidou A, Pazaitou-Panayiotou K, Flaris N, Drimonitis A, Giavroglou I, Glinikopoulou E, Vainas I (2004) Pituitary metastases of follicular carcinoma. Horm Res 61:190–192PubMedCrossRefGoogle Scholar
  12. 12.
    Palosi RM, Romaldini JH, Massuda LT, Reiss LCF, Franca LCM (1977) Panhipopituitarismo por metástase de carcinoma papilifero da tiroide, com tromboflebite secundária de seio cavernoso leptomeningite purulenta. Rev Ass Med Brasil 23:277–280Google Scholar
  13. 13.
    Sziklas JJ, Mathew SJ, Spencer RP, Rosenberg RJ, Ergin MT, Bower BF (1985) Thyroid carcinoma metastatic to pituitary. J Nucl Med 26:1097PubMedGoogle Scholar
  14. 14.
    Masiukiewicz US, Nakchbandi IA, Stewart AF, Inzucchi SE (1999) Papillary thyroid carcinoma metastatic to the pituitary gland. Thyroid 9:1023–1027PubMedCrossRefGoogle Scholar
  15. 15.
    Albores-Saavedra J, LiVolsi VA, Williams ED (1985) Medullary carcinoma. Semin Diagn Pathol 2:137–146PubMedGoogle Scholar
  16. 16.
    Girelli ME, Nacamulli D, Pelizzo MR et al (1998) Medullary thyroid carcinoma: clinical features and long-term follow-up of seventy eight patients treated between 1979 and 1986. Thyroid 8:517–523PubMedGoogle Scholar
  17. 17.
    Hijazi YM, Nieman LK, Medeiros LJ (1992) Medullary carcinoma of the thyroid as a cause of Cushing’s syndrome: a case with ectopic adrenocorticotropin secretion characterized by double enzyme immunostaining. Hum Pathol 23:592–596PubMedCrossRefGoogle Scholar
  18. 18.
    Howlett TA, Price J, Hale AC et al (1985) Pituitary ACTH dependent Cushing’s syndrome due to ectopic production of a bombesin-like peptide by a medullary carcinoma of the thyroid. Clin Endocrinol 22:91–101CrossRefGoogle Scholar
  19. 19.
    Goglia U, Ferone D, Sidoti M et al (2007) Treatment of a pituitary metastasis from a neuroendocrine tumour: case report and literature review. Pituitary 26: epub ahead of printGoogle Scholar
  20. 20.
    Trunnell JB, Marinelli LD, Duffy BJ, Hill R, Peacock W, Rawson RW (1949) The treatment of metastatic thyroid cancer with radioactive iodine. Credits and debits. J Clin Endocrin 9:1138–1152Google Scholar
  21. 21.
    Johnson PM, Atkins HL (1965) Functioning metastasis of thyroid carcinoma in sella turcica. J Clin Endocrin 25:1126–1130CrossRefGoogle Scholar
  22. 22.
    Kistler M, Fribram HW (1975) Metastatic disease of the sella turcica. AJR 125:13–21Google Scholar
  23. 23.
    Ochiai H, Nakano S, Goya T, Wakisaka S, Kinoshita K (1992) Pituitary metastasis of thyroid follicular adenocarcinoma. Case report. Neurol Med Chir (Tokyo) 32:851–853CrossRefGoogle Scholar
  24. 24.
    Yilmazlar S, Kocaeli H, Cordan T (2004) Sella turcica metastasis from follicular carcinoma of thyroid. Neurol Res 26:74–78PubMedCrossRefGoogle Scholar
  25. 25.
    Simon N, Quyyumi SA, Rothman JG (2004) Follicular thyroid cancer presenting as a sellar mass: case report and review of literature. Endocr Pract 10:62–66PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Harjinder S. Bhatoe
    • 1
    Email author
  • Sonia Badwal
    • 2
  • Vibha Dutta
    • 2
  • N. Kannan
    • 3
  1. 1.Department of NeurosurgeryArmy Hospital (Research & Referral)New DelhiIndia
  2. 2.Department of OncopathologyArmy Hospital (Research & Referral)New DelhiIndia
  3. 3.Department of Surgical OncologyArmy Hospital (Research & Referral)New DelhiIndia

Personalised recommendations