2.3.3 Metastatic Sellar Lesions

Suggested citation: The Endocrine Society. Endocrine Facts and Figures: Hypothalamic-Pituitary. First Edition. 2016

On this page Prevalence and Incidence

Metastatic disease to the sella is uncommon, and there are limited available data regarding the clinical aspects of this disease.114 Ariel et al. reported that the most common neoplastic sources to the sella were breast and renal cell carcinomas. Specifically, six patients (46%) had breast carcinoma, three (23%) had renal cell carcinoma, two (15%) had squamous cell carcinoma of the head and neck, one had bronchoalveolar carcinoma of the lung, and one had nodular sclerosing Hodgkin’s lymphoma.114

Secondary hypothyroidism was the most common endocrine abnormality, followed by diabetes insipidus and adrenal insufficiency.114 Demographic Differences

In the study by Ariel and colleagues nine out of 13 subjects were female. The mean age at diagnosis was 55 years (range, 25 to 73 years).114 Key Trends and Health Outcomes

In the study by Ariel, the most common presenting signs and symptoms were headache (58%), followed by fatigue (50%), polyuria (50%), visual field defects (42%), and ophthalmoplegia (42%). Seventy-five percent of patients presented with at least one pituitary hormone insufficiency, which included six patients (50%) with diabetes insipidus. Eight (67%) subjects had secondary hypothyroidism and five (45%) had secondary adrenal insufficiency. Of the patients with stalk involvement, 86% had diabetes insipidus. All patients had a prior diagnosis of malignancy, with a mean duration of 95 months.114



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