A CASE ILLUSTRATION AND LITERATURE REVIEW OF THYROID CANCER METASTASIS TO THE PITUITARY FOSSA

Abstract

Abstract AIMS To understand the clinico-radiological and histopathological features, treatment strategies and outcomes of patients with thyroid cancer metastasis to the pituitary fossa. METHOD A 71-year-old man presented with a few months’ history of headaches, blurred vision, diplopia and right sided ptosis. MRI head revealed a 2.5cm pituitary fossa lesion distorting the optic chiasm with right sided cavernous sinus invasion. It also showed frontal, temporal and parieto-occipital lesions. CT thorax, abdomen and pelvis found a retrosternal thyroid goitre. An open biopsy of the occipital lobe lesion revealed a metastatic papillary adenocarcinoma from the thyroid gland. An ultrasound-guided fine needle aspiration of the goitre and abnormal level IV lymph nodes revealed Thy5. The patient subsequently underwent an endoscopic transsphenoidal resection of the pituitary tumour which was confirmed to be a carcinoma. A date and language unrestricted literature search was performed across the MEDLINE, Embase (via Ovid) and Scopus databases using keywords relating metastasis, the pituitary & thyroid glands, and the brain. Citations reporting patients with thyroid metastasis to the pituitary fossa were included. A predetermined proforma was used to extract and store data from the included citations. RESULTS After de-duplication, 2,833 citations were screened for eligibility and 42 citations met the inclusion criteria. CONCLUSIONS We present a rare case illustration and literature review of patients with thyroid cancer metastasis to the pituitary fossa.