Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Intracranial metastases from laryngeal carcinoma are rarely clinically diagnosed. To our knowledge, this is the first report of hypopituitarism due to pituitary metastasis from laryngeal carcinoma. We report on a 70-year-old man who had a supraglottic squamous cell carcinoma, which was resected surgically followed by local full dose radiation therapy. Four months later, he presented with a sudden onset of diplopia, syncope, headache, general malaise and loss of appetite. Magnetic resonance imaging of the brain revealed a tumorous process of the sellar region. Endocrinological tests disclosed the presence of hypopituitarism. The tumor was subtotally resected endoscopically via endonasal transsphenoidal approach. Histopathology of tumor specimens indicated squamous cell carcinoma. Tumors of the sellar and parasellar region as in the case presented may easily be confused with pituitary adenoma. Pituitary metastases should be considered on differential diagnosis of unusual pituitary tumors, especially in patients with as well as in those without a history of malignant disease.Intrakranijske metastaze karcinoma larinksa se rijetko dijagnosticiraju. Prema našim spoznajama, ovo je prvi zabilježeni slučaj hipopituitarizma uzrokovanog metastazom karcinoma larinksa u hipofizu. Prikazujemo slučaj muškarca u dobi od 70 godina kojemu je dijagnosticiran supraglotički planocelularni karcinom larinksa koji je kirurški uklonjen te je provedena lokalna radioterapija u punoj dozi. Četiri mjeseca kasnije javljaju se naglo nastale dvoslike, glavobolja, sinkopa, opća slabost i gubitak apetita. Učinjena je MR mozga te je otkriven tumorski proces selarne i paraselarne regije. Endokrinološkim testovima otkriveno je postojanje hipopituitarizma. Tumor je djelomice odstranjen endonazalnim transsfenoidnim pristupom. Patohistološki nalaz pokazao je planocelularni karcinom. Tumori selarne i paraselarne regije, kao u ovom slučaju, lako se zamijene za adenom hipofize. Metastaze u hipofizu bi trebalo razmotriti u diferencijalnoj dijagnozi neobičnih tumora hipofize, pogotovo u bolesnika s poviješću maligne bolesti, ali također i u onih bez nje
