Thyroid cancer metastasis to the pituitary fossa: A clinical analysis and literature review

Abstract

Background: A 71-year-old man presented with a history of headaches, blurred vision, diplopia, and right-sided ptosis. Magnetic resonance imaging (MRI) of the head revealed a 2.5 cm pituitary fossa lesion distorting the optic chiasm, with cavernous sinus invasion and frontal, temporal, and parieto-occipital lesions. Computed tomography (CT) found a retrosternal thyroid goiter. Biopsy of the occipital lobe lesion revealed metastatic papillary adenocarcinoma. Ultrasound-guided fine needle aspiration of the goiter and abnormal lymph nodes revealed Thy5. The patient underwent endoscopic transsphenoidal resection of the pituitary tumor, confirming papillary carcinoma of the thyroid. We sought to understand the clinico-radiological and histopathological features, treatment strategies, and outcomes of patients with thyroid cancer metastasis to the pituitary fossa.

Materials and methods: A date- and language-unrestricted literature search was performed across the MEDLINE, Embase, and Scopus databases using keywords relating to metastasis, the pituitary and thyroid glands, and the brain. Citations reporting patients with thyroid metastasis to the pituitary fossa were included. A proforma was used to extract and store data from the included citations.

Results: After deduplication, 2,833 citations were screened for eligibility, and 49 citations were included in the analysis.

Conclusion: We present a rare case illustration and comprehensive literature review of patients with thyroid cancer metastasis to the pituitary fossa.