J Neurol Surg A Cent Eur Neurosurg 2023; 84(03): 295-299
DOI: 10.1055/s-0041-1735857
Case Report

Differential Diagnosis in Hypophysitis: First Report on a Spindle Cell Rhabdomyosarcoma of the Pituitary Gland

Hajrullah Ahmeti
1   Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany
,
Eva Jüttner
2   Department of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
,
Christoph Röcken
2   Department of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
,
Olav Jansen
3   Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
,
Matthias Laudes
4   Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany
,
Michael Synowitz
1   Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany
› Author Affiliations

Abstract

Pituitary gland metastases are very rare. Most patients with pituitary gland metastases are asymptomatic; therefore, most cases of this disease are diagnosed during autopsies. Moreover, the four most common primary tumors that metastasize to the pituitary gland are breast, lung, thyroid, and renal carcinomas. We present a very rare case of pituitary metastasis of spindle cell rhabdomyosarcoma (RMS). Our patient presented with headache, visual disorder, panhypopituitarism, and diabetes insipidus. Due to tumor expansion, resection was not possible, so diagnosis was confirmed by biopsy, and chemotherapy and irradiation were administered. Our patient showed widespread spindle cell RMS, which harbors a mutation of myogenic differentiation 1 (MYOD1) and is associated with a poor prognosis. Even high-risk patients can show a remission after chemotherapy and irradiation. In the cases with indistinct lesions in the sella region, pituitary metastasis should always be considered.

Supplementary Material



Publication History

Received: 10 December 2020

Accepted: 09 March 2021

Article published online:
15 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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