Pituitary apoplexy caused by hemorrhage from pituitary metastatic melanoma: case report

Neurol Med Chir (Tokyo). 2013;53(10):695-8. doi: 10.2176/nmc.cr2012-0068. Epub 2013 Sep 27.

Abstract

Melanoma metastases to the pituitary gland are extremely rare, with only a few reported cases. We report an unusual case of pituitary metastatic melanoma in which the patient presented with pituitary apoplexy. A 68-year-old man presented general fatigue and anorexia following sudden headache. Neurological examination disclosed bitemporal hemianopsia. Computed tomography (CT) scans revealed a suprasellar mass including intratumoral hematoma. Magnetic resonance (MR) images demonstrated a circumscribed mass lesion in the intra- and suprasellar regions, compressing the optic chiasm. Surgical exploration was performed through a transsphenoidal approach, and a mixture of tumor and necrotic tissue with old hematoma was obtained. The histological examination of the specimen revealed a partly necrotic, malignant tumor with focal melanotic pigmentation. Histopathologically, the diagnosis was consistent with pituitary apoplexy caused by hemorrhage from pituitary metastatic melanoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Gastroscopy
  • Hemianopsia / etiology
  • Humans
  • Hypophysectomy
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / blood supply
  • Melanoma / complications
  • Melanoma / secondary*
  • Melanoma / surgery
  • Necrosis
  • Neoplasms, Unknown Primary / diagnosis
  • Neoplasms, Unknown Primary / pathology
  • Pituitary Apoplexy / etiology*
  • Pituitary Neoplasms / blood supply
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / secondary*
  • Pituitary Neoplasms / surgery
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / pathology
  • Tomography, X-Ray Computed