Pituitary metastasis of malignant melanoma misdiagnosed as pituitary adenoma: A case report and systematic review of the literature

Abstract

We report a case of malignant melanoma revealed by a metastasis to the pituitary gland. The tumor was misdiagnosed as a pituitary adenoma and aggressive transsphenoidal surgery was complicated by a cerebrospinal fluid fistula. Nine weeks later, the patient presented multiple leptomeningeal and brain metastases spreading from the sellar region. Regarding these observations, we conducted a systematic review of the literature in order to investigate clinicoradiological features that should lead clinicians to suspect pituitary metastasis and how it should impact the surgical management.

Keywords: Chirurgie endoscopique; Dissémination leptoméningée; Endoscopic surgery; Hypophyse; Leptomeningeal carcinomatosis; Melanoma; Metastasis; Mélanome; Métastase; Pituitary; Transsphenoidal; Transsphénoidal.