Metastatic Tumors of the Sella Turcica Masquerading as Primary Pituitary Tumors

Tumors metastatic to the pituitary gland are uncommon, but may mimic a typical pituitary adenoma and are an important part of the differential diagnosis of sellar mass lesions. Pituitary metastases were treated by transsphenoidal microsurgical removal in 14 patients. Most tumors appeared in men in the sixth and seventh decades of life. Half of the patients presented with visual loss, 6 had anterior hypopituitarism, and 4 had diabetes insipidus. Primary cancer had been diagnosed and treated previously in 5 patients. In the remaining 9 patients, the transsphenoidal operation provided the initial diagnosis of cancer, and primary lesions subsequently were detected in all but 2. Transsphenoidal surgery also provided satisfactory decompression of the mass effect related to the tumors, improving the presenting symptoms in the majority of patients, and the surgery was free of mortality or serious complications.