Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report

Abstract Background Pituitary metastases are rare, often deriving from lung or breast cancer owing to the upper vena cava proximity. Pituitary metastases can manifest with signs and symptoms of pituitary tumors, consequent to mass effect (headache, visual impairment) and/or hormonal alterations (hyp...

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Autores principales:	Giuseppe Giuffrida, Francesco Ferraù, Ylenia Alessi, Salvatore Cannavò
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pituitary tumors Pituitary metastases Immune checkpoint inhibitors Case report Medicine R
Acceso en línea:	https://doaj.org/article/9ff93829c57643e28f7e53483b52468a
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spelling	oai:doaj.org-article:9ff93829c57643e28f7e53483b52468a2021-11-14T12:37:51ZShrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report10.1186/s13256-021-03150-41752-1947https://doaj.org/article/9ff93829c57643e28f7e53483b52468a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13256-021-03150-4https://doaj.org/toc/1752-1947Abstract Background Pituitary metastases are rare, often deriving from lung or breast cancer owing to the upper vena cava proximity. Pituitary metastases can manifest with signs and symptoms of pituitary tumors, consequent to mass effect (headache, visual impairment) and/or hormonal alterations (hyperprolactinemia, hypopituitarism, and diabetes insipidus). Immune checkpoint inhibitors burst immunity against tumors, significantly increasing patients’ survival, but their autoimmune side effects frequently involve the skin, the gastrointestinal tract, and the endocrine glands (pituitary, thyroid, pancreas). Case presentation A 77-year-old Caucasian man had undergone trans-nasal sphenoidal surgery for a nonsecreting pituitary macroadenoma in 2001, without remnant or endocrine deficits. In 2016, he was operated for a shoulder melanoma. In February 2018, imaging evaluation demonstrated metastases in lung, liver, and femur. Therefore, treatment with pembrolizumab (anti-programmed death 1) was scheduled in May 2018, but, before starting this therapy, a brain computed tomography performed for a sudden loss of consciousness detected a sellar mass of 17 × 12 mm, which extended to the pituitary stalk and compressed the optic chiasma. Focused magnetic resonance imaging confirmed the size and characteristics of the lesion, while emergency evaluation of the hormonal profile demonstrated an impairment of adrenal and thyroid function. The pituitary lesion demonstrated a remarkable shrinkage (8 × 6 mm), which was confirmed by subsequent imaging evaluations. Conclusions This is the first case reporting on effectiveness of immune checkpoint inhibitors in a patient with pituitary metastasis from a melanoma.Giuseppe GiuffridaFrancesco FerraùYlenia AlessiSalvatore CannavòBMCarticlePituitary tumorsPituitary metastasesImmune checkpoint inhibitorsCase reportMedicineRENJournal of Medical Case Reports, Vol 15, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pituitary tumors Pituitary metastases Immune checkpoint inhibitors Case report Medicine R
spellingShingle	Pituitary tumors Pituitary metastases Immune checkpoint inhibitors Case report Medicine R Giuseppe Giuffrida Francesco Ferraù Ylenia Alessi Salvatore Cannavò Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
description	Abstract Background Pituitary metastases are rare, often deriving from lung or breast cancer owing to the upper vena cava proximity. Pituitary metastases can manifest with signs and symptoms of pituitary tumors, consequent to mass effect (headache, visual impairment) and/or hormonal alterations (hyperprolactinemia, hypopituitarism, and diabetes insipidus). Immune checkpoint inhibitors burst immunity against tumors, significantly increasing patients’ survival, but their autoimmune side effects frequently involve the skin, the gastrointestinal tract, and the endocrine glands (pituitary, thyroid, pancreas). Case presentation A 77-year-old Caucasian man had undergone trans-nasal sphenoidal surgery for a nonsecreting pituitary macroadenoma in 2001, without remnant or endocrine deficits. In 2016, he was operated for a shoulder melanoma. In February 2018, imaging evaluation demonstrated metastases in lung, liver, and femur. Therefore, treatment with pembrolizumab (anti-programmed death 1) was scheduled in May 2018, but, before starting this therapy, a brain computed tomography performed for a sudden loss of consciousness detected a sellar mass of 17 × 12 mm, which extended to the pituitary stalk and compressed the optic chiasma. Focused magnetic resonance imaging confirmed the size and characteristics of the lesion, while emergency evaluation of the hormonal profile demonstrated an impairment of adrenal and thyroid function. The pituitary lesion demonstrated a remarkable shrinkage (8 × 6 mm), which was confirmed by subsequent imaging evaluations. Conclusions This is the first case reporting on effectiveness of immune checkpoint inhibitors in a patient with pituitary metastasis from a melanoma.
format	article
author	Giuseppe Giuffrida Francesco Ferraù Ylenia Alessi Salvatore Cannavò
author_facet	Giuseppe Giuffrida Francesco Ferraù Ylenia Alessi Salvatore Cannavò
author_sort	Giuseppe Giuffrida
title	Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
title_short	Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
title_full	Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
title_fullStr	Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
title_full_unstemmed	Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
title_sort	shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9ff93829c57643e28f7e53483b52468a
work_keys_str_mv	AT giuseppegiuffrida shrinkageofapituitarymetastasisofmelanomainducedbypembrolizumabacasereport AT francescoferrau shrinkageofapituitarymetastasisofmelanomainducedbypembrolizumabacasereport AT yleniaalessi shrinkageofapituitarymetastasisofmelanomainducedbypembrolizumabacasereport AT salvatorecannavo shrinkageofapituitarymetastasisofmelanomainducedbypembrolizumabacasereport
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Shrinkage of a pituitary metastasis of melanoma induced by pembrolizumab: a case report

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