Pituitary metastases of Hürthle cell carcinoma of the thyroid. Issue 1 (18th January 2021)

• Record Type: Journal Article
• Authors: Ilerhunmwuwa, Nosakhare Paul; Goldspring, Robert; Page, Simon; Gouni, Ravikanth
• Is Part Of: BMJ case reports. Volume 14:Issue 1(2021)
• Publication Date: 2021-01-18
• Subjects: pituitary disorders -- thyroid disease; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-239456
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : An 85-year-old man was referred to endocrinology following the discovery of an incidental pituitary mass on cranial imaging which was thought to be a non-functioning adenoma during an admission with headaches, lethargy, confusion and hyponatraemia. He had a history of Hürthle cell carcinoma of the thyroid treated with total thyroidectomy, ablative radioiodine therapy and thyroxine replacement. Subsequently, he developed metastatic spread to the neck, lungs and skeleton. About 9 months later, the patient had deterioration of vision. MRI showed a rapidly expanding pituitary mass with compression of the optic chiasm. Biochemical investigations confirmed hypocortisolism and hypogonadism. The patient underwent trans-sphenoidal resection of the pituitary mass followed by external beam radiotherapy to the pituitary bed. Histopathology confirmed a metastatic deposit of Hürthle cell carcinoma, which is a rare and aggressive variant of follicular thyroid carcinoma.