{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:10:03Z","timestamp":1756321803210,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Medstar Health Graduate Medical Education"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,24]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Pituitary metastases, especially from a primary hepatocellular carcinoma (HCC), are rare. Review of the literature revealed only few cases reporting pituitary metastases complicated by panhypopituitarism from HCC. Calvarial metastases from HCC are even more rare. Here, we present a unique case of primary HCC with metastases to both the calvarium and the pituitary causing panhypopituitarism and bilateral ophthalmoplegia, respectively. To our knowledge, this is the first reported case of two unique and rare complications from metastatic HCC.<\/jats:p>","DOI":"10.1136\/bcr-2020-236377","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T17:05:43Z","timestamp":1603818343000},"page":"e236377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Rare case of hepatocellular carcinoma metastasising to the pituitary and cavernous sinus causing panhypopituitarism and bilateral ophthalmoplegia"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6923-8728","authenticated-orcid":false,"given":"Jayachidambaram","family":"Ambalavanan","sequence":"first","affiliation":[{"name":"Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Peravali","sequence":"additional","affiliation":[{"name":"Hematology and Oncology, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Perry","sequence":"additional","affiliation":[{"name":"Hematology and Oncology, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"2025082711563231000_13.10.e236377.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(05)70058-X"},{"key":"2025082711563231000_13.10.e236377.2","first-page":"236","article-title":"Diagnosis, treatment, and outcome of pituitary tumors and other abnormal intrasellar masses","volume":"78","author":"Gsponer","year":"1999","journal-title":"Pdf Med"},{"key":"2025082711563231000_13.10.e236377.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF00588159"},{"key":"2025082711563231000_13.10.e236377.4","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.1.0069"},{"key":"2025082711563231000_13.10.e236377.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3229-9"},{"key":"2025082711563231000_13.10.e236377.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2004.16.4.9","article-title":"Metastases to the pituitary gland","volume":"16","author":"Fassett","year":"2004","journal-title":"Neurosurg Focus"},{"key":"2025082711563231000_13.10.e236377.7","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1009-3"},{"key":"2025082711563231000_13.10.e236377.8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1023\/A:1023994604919","article-title":"Hepatocellular carcinoma metastasis in the pituitary gland: case report and review of the literature","volume":"63","author":"Karamouzis","year":"2003","journal-title":"J Neurooncol"},{"key":"2025082711563231000_13.10.e236377.9","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s12328-013-0384-z","article-title":"Hepatocellular carcinoma metastasis to the brain mimicking primary pituitary tumor around the sella turcica","volume":"6","author":"Tamura","year":"2013","journal-title":"Clin J Gastroenterol"},{"key":"2025082711563231000_13.10.e236377.10","doi-asserted-by":"crossref","first-page":"471","DOI":"10.4103\/0976-9668.160045","article-title":"An unusual initial presentation of hepatocellular carcinoma as a sellar mass","volume":"6","author":"Shah","year":"2015","journal-title":"J Nat Sci Biol Med"},{"key":"2025082711563231000_13.10.e236377.11","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1055\/s-0039-1685207","article-title":"Clival metastasis of hepatocellular carcinoma with an initial histopathological diagnosis of atypical pituitary adenoma","volume":"80","author":"Mishima","year":"2019","journal-title":"J Neurol Surg Rep"},{"key":"2025082711563231000_13.10.e236377.12","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030395"},{"key":"2025082711563231000_13.10.e236377.13","first-page":"48","article-title":"Hepatocellular carcinoma with metastasis to the skull base, pituitary gland, sphenoid sinus, and cavernous sinus","volume":"8","author":"Aung","year":"2002","journal-title":"Hong Kong Med J"},{"key":"2025082711563231000_13.10.e236377.14","doi-asserted-by":"crossref","unstructured":"Larocca G , Mattogno PP , Pompucci A , et al . An extremely rare case of a single isolated pituitary metastasis from hepatocellular carcinoma. vol. 61, Journal of neurosurgical sciences. 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