Metástasis hipotálamo-hipofisaria en paciente con cáncer de mama

Pan-hypopituitarism is an unusual initial clinical presentation of metastatic stage breast cancer. Breast and lung cancers are the most frequent sites in women and in men associated with parasellar metastasis and hypothalamic invasion. Reported incidence of pituitary metastases is <5%. Treatment is, essentially, palliative and depends on the symptoms, the extent of the systemic disease, and the performance status of the patient. Prognosis is poor not only because the location of the metastasis but because of the aggressiveness of the primary neoplasia. We report, here, the case of a 59 year-old woman with a medical history that included breast cancer in 1989 and colon cancer in 1998. She was admitted to our hospital with general malaise and hypoglycaemia. Endocrine testing revealed pan-hypopituitarism, and magnetic resonance imaging showed thickening of the pituitary stalk.