NCMP-08. TREATMENT OF PITUITARY METASTASIS: A SINGLE CENTER EXPERIENCE AND SYSTEMATIC LITERATURE REVIEW

Abstract

Abstract PURPOSE To understand the natural history and optimal treatment strategy for pituitary gland metastasis. METHODS We performed both a retrospective chart review of patients treated at our institution and a scoping review of the topic. RESULTS The retrospective review identified seven patients with an average age of 59.6. Primary histologies included breast cancer (4), melanoma (1), renal carcinoma (1), and sarcoma (1). Two patients had anterior pituitary endocrine dysfunction, one of whom was the only patient with visual symptoms. All patients were treated with radiosurgery and two also underwent surgical resection. Overall survival ranged from 6.5 – 117 months. We identified 166 patients from 71 studies in our literature review. The most common primary cancer was lung (27.7%), followed by breast (18.7%) and renal (14.5%) cancer. 107 presented with endocrine dysfunction; with 41 cases of diabetes insipidus and 55 cases of hypopituitarism. 110 presented with visual compromise. 107 patients received radiotherapy, 96 underwent surgical resection and 44 received systemic chemotherapy/immunotherapy. Surgery was significantly associated with an increased likelihood of vision improvement and a decreased likelihood of endocrine normalization. Radiographic regression predicted visual improvement. Median overall survival was 9.9 months (range: 0.2 – 96). CONCLUSIONS Our scoping review showed that both radiosurgery and surgical resection have been frequently used to treat pituitary metastases with good response. Vision improvement is more likely to happen following surgical resection. Despite treatment and radiographic response, patient survival remains less than a year.