Symptomatic pituitary metastasis from hepatocellular carcinoma: a case report and literature review

Context: Pituitary metastasis is a rare situation in clinical practice and has been estimated to take up no more than 1% of tumors found in sellar region, in which the incidence of secondary metastatic lesion to the sella by hepatocellular carcinoma (HCC) is extremely rare, only 15 cases of which has been reported yet. The aim of this study is to share the detailed procedures and clinical strategies of this rare case and review the whole 15 HCC-derived PM cases since 1857. Case Description: We present an extremely rare case of a HCC metastasis to the pituitary gland with his condition and clinical course. We then discuss the dominant diagnosis and clinicial therapy of HCC-derived PM and review the literature. Conclusion: This case demonstrated the difficulties encountered in the diagnosis of PM and the need for accurate judgement when confronting pituitary tumors with atypical features. In addition, the appropriate therapy need to be well considered, because of the poor prognosis and severe symptoms.

背景：垂体转移瘤（pituitary metastasis）在临床实践中较为罕见，据统计其占鞍区检出肿瘤的比例不超过1%；其中肝细胞癌（hepatocellular carcinoma, HCC）继发鞍区转移灶的发生率极低，截至目前仅报道过15例相关病例。本研究旨在分享该罕见病例的详细诊疗流程与临床策略，并回顾自1857年以来全部15例肝细胞癌来源的垂体转移瘤病例。
病例报告：本文报告1例极为罕见的肝细胞癌垂体转移病例，详述其病情与临床病程。随后讨论肝细胞癌来源垂体转移瘤的主要诊断与临床治疗方案，并对相关文献进行综述。
结论：本病例凸显了垂体转移瘤诊断过程中面临的重重困难，当遇到具有非典型特征的垂体肿瘤时，需做出精准判断。此外，由于此类病例预后较差且症状严重，临床需审慎考量合适的治疗方案。