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

Hajrullah Ahmeti; Eva Jüttner; Christoph Röcken; Olav Jansen; Matthias Laudes; Michael Synowitz

doi:10.1055/s-0041-1735857

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

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

¹Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany

,

Eva Jüttner

²Department of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany

,

Christoph Röcken

²Department of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany

,

Olav Jansen

³Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany

,

Matthias Laudes

⁴Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Schleswig-Holstein, Germany

,

Michael Synowitz

¹Department 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.

Keywords

pituitary metastases - rhabdomyosarcoma - panhypopituitarism - mutation of myogenic differentiation 1

Full Text

References

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Supplementary Material

Supplementary Material