{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:57:12Z","timestamp":1781053032820,"version":"3.54.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"23","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,6,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Pituitary metastases represent approximately 1% of all pituitary tumors and are associated with a poor prognosis. Although rare, early diagnosis and treatment are critical to limit rapid clinical decline. Because of their rarity, published data remain limited. The authors report their institutional experience at The Ottawa Hospital, focusing on clinical and radiological presentation, surgical management, adjuvant therapy, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors retrospectively reviewed the cases of adult patients undergoing endoscopic endonasal skull base surgery for pituitary metastases between 2016 and 2025. Inclusion criteria were histopathological confirmation and complete clinical data. Four patients (mean age 57 years) were identified; 3 had known primary malignancies. All of the patients had cranial nerve (CN) deficits. Headache was the most common symptom, followed by visual disturbance; diabetes insipidus occurred in 2 patients. Imaging showed bone erosion in all cases and cavernous sinus invasion in 1 patient. All patients underwent endoscopic resection. Tumors were adherent and highly vascular, requiring meticulous microsurgical dissection and hemostatic agents. Postoperative complications were minimal, with one CSF leak. All patients received adjuvant radiotherapy. CN improvement occurred in 3 patients. Three patients died, with a mean survival of 6.3 months postdiagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Pituitary metastases are associated with rapid clinical deterioration and poor survival. Multidisciplinary management and further research are needed to improve outcomes.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26115\">https:\/\/thejns.org\/doi\/10.3171\/CASE26115<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26115","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:41Z","timestamp":1780444841000},"source":"Crossref","is-referenced-by-count":0,"title":["Pituitary metastasis revisited: a retrospective single-center experience with diagnostic challenges and surgical nuances. Illustrative cases"],"prefix":"10.3171","volume":"11","author":[{"given":"Sara Khalid","family":"Dabbour","sequence":"first","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4440-7734","authenticated-orcid":true,"given":"Wareef W.","family":"AlGhamdi","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Vargas-Moreno","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Khairy","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-9266","authenticated-orcid":true,"given":"Damanpreet Kaur","family":"Lang","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Research Institute, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Ottawa Hospital, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Rabski","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Kilty","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Ottawa Hospital, Ottawa, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alkherayf","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario"},{"name":"The Ottawa Hospital Research Institute, Ottawa, Ontario"},{"name":"Division of Neurosurgery, University of Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Ulster Med J","first-page":"146","article-title":"Pituitary metastasis: a clinical overview","volume":"90","author":"Henry","year":"2021","unstructured":"Henry ANugent AWallace IROladipo BSheehy OJohnston PC.Pituitary metastasis: a clinical overview. Ulster Med J. 2021;90(3):146-150."},{"key":"bib2","series-title":"J Clin Transl Endocrinol Case Rep","first-page":"100080","article-title":"Pituitary metastasis of small cell lung cancer: two case reports","volume":"19","author":"Martinez Quintero","year":"2021","unstructured":"Martinez Quintero BDoe KKBunker BChow WYavuz S.Pituitary metastasis of small cell lung cancer: two case reports. J Clin Transl Endocrinol Case Rep. 2021;19:100080. doi:10.1016\/j.jecr.2021.100080"},{"issue":"2","key":"bib3","series-title":"J Clin Endocrinol Metab","first-page":"574","article-title":"Tumors metastatic to the pituitary gland: case report and literature review","volume":"89","author":"Komninos","year":"2004","unstructured":"Komninos JVlassopoulou VProtopapa DTumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab. 2004;89(2):574-580. doi:10.1210\/jc.2003-030395"},{"issue":"10","key":"bib4","series-title":"Endocr Connect","first-page":"1049","article-title":"Pituitary metastasis: a rare condition","volume":"7","author":"Javanbakht","year":"2018","unstructured":"Javanbakht AD\u2019Apuzzo MBadie BSalehian B.Pituitary metastasis: a rare condition. Endocr Connect. 2018;7(10):1049-1057. doi:10.1530\/EC-18-0338"},{"issue":"15","key":"bib5","series-title":"World J Clin Cases","first-page":"2597","article-title":"Pituitary metastasis from lung adenocarcinoma: a case report","volume":"12","author":"Wang","year":"2024","unstructured":"Wang QLiu XWChen KY.Pituitary metastasis from lung adenocarcinoma: a case report. World J Clin Cases. 2024;12(15):2597-2605. doi:10.12998\/wjcc.v12.i15.2597"},{"issue":"1","key":"bib6","series-title":"BMC Endocr Disord","first-page":"114","article-title":"Diabetes insipidus and panhypopituitarism as a first presentation of silent adenocarcinoma of lung: a case report and literature review","volume":"19","author":"Sirinvaravong","year":"2019","unstructured":"Sirinvaravong SVibhatavata PChunharojrith PCheunsuchon PSriussadaporn S.Diabetes insipidus and panhypopituitarism as a first presentation of silent adenocarcinoma of lung: a case report and literature review. BMC Endocr Disord. 2019;19(1):114. doi:10.1186\/s12902-019-0445-5"},{"issue":"1","key":"bib13","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum","volume":"19","author":"Kassam","year":"2005","unstructured":"KassamASnydermanCHMintzAGardnerPCarrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus. 2005;19(1):E4."},{"key":"bib7","series-title":"World J Surg Oncol","first-page":"137","article-title":"Breast cancer metastatic to the pituitary gland: a case report","volume":"10","author":"Spinelli","year":"2012","unstructured":"Spinelli GPLo Russo GMiele EBreast cancer metastatic to the pituitary gland: a case report. World J Surg Oncol. 2012;10:137. doi:10.1186\/1477-7819-10-137"},{"key":"bib8","series-title":"Endocrinol Diabetes Metab Case Rep","first-page":"130024","article-title":"Pituitary metastases from papillary carcinoma of thyroid: a case report and literature review","volume":"2013","author":"Chikani","year":"2013","unstructured":"Chikani VLambie DRussell A.Pituitary metastases from papillary carcinoma of thyroid: a case report and literature review. Endocrinol Diabetes Metab Case Rep. 2013;2013:130024. doi:10.1530\/EDM-13-0024"},{"issue":"9","key":"bib9","series-title":"Clin Case Rep","first-page":"e7808","article-title":"Pituitary metastasis from renal cell carcinoma presenting with significant hyperprolactinemia, case report","volume":"11","author":"Mazar-Atabaki","year":"2023","unstructured":"Mazar-Atabaki AMohamadzadeh OSadrehosseini SMTabari AZeinalizadeh M.Pituitary metastasis from renal cell carcinoma presenting with significant hyperprolactinemia, case report. 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World Neurosurg. 2023;172:e684-e694. doi:10.1016\/j.wneu.2023.02.002"},{"issue":"3","key":"bib1","series-title":"Ulster Med J","first-page":"146","article-title":"Pituitary metastasis: a clinical overview","volume":"90","author":"Henry","year":"2021","unstructured":"Henry ANugent AWallace IROladipo BSheehy OJohnston PC.Pituitary metastasis: a clinical overview. Ulster Med J. 2021;90(3):146-150."},{"key":"bib2","series-title":"J Clin Transl Endocrinol Case Rep","first-page":"100080","article-title":"Pituitary metastasis of small cell lung cancer: two case reports","volume":"19","author":"Martinez Quintero","year":"2021","unstructured":"Martinez Quintero BDoe KKBunker BChow WYavuz S.Pituitary metastasis of small cell lung cancer: two case reports. J Clin Transl Endocrinol Case Rep. 2021;19:100080. doi:10.1016\/j.jecr.2021.100080"},{"issue":"2","key":"bib3","series-title":"J Clin Endocrinol Metab","first-page":"574","article-title":"Tumors metastatic to the pituitary gland: case report and literature review","volume":"89","author":"Komninos","year":"2004","unstructured":"Komninos JVlassopoulou VProtopapa DTumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab. 2004;89(2):574-580. doi:10.1210\/jc.2003-030395"},{"issue":"10","key":"bib4","series-title":"Endocr Connect","first-page":"1049","article-title":"Pituitary metastasis: a rare condition","volume":"7","author":"Javanbakht","year":"2018","unstructured":"Javanbakht AD\u2019Apuzzo MBadie BSalehian B.Pituitary metastasis: a rare condition. Endocr Connect. 2018;7(10):1049-1057. doi:10.1530\/EC-18-0338"},{"issue":"15","key":"bib5","series-title":"World J Clin Cases","first-page":"2597","article-title":"Pituitary metastasis from lung adenocarcinoma: a case report","volume":"12","author":"Wang","year":"2024","unstructured":"Wang QLiu XWChen KY.Pituitary metastasis from lung adenocarcinoma: a case report. World J Clin Cases. 2024;12(15):2597-2605. doi:10.12998\/wjcc.v12.i15.2597"},{"issue":"1","key":"bib6","series-title":"BMC Endocr Disord","first-page":"114","article-title":"Diabetes insipidus and panhypopituitarism as a first presentation of silent adenocarcinoma of lung: a case report and literature review","volume":"19","author":"Sirinvaravong","year":"2019","unstructured":"Sirinvaravong SVibhatavata PChunharojrith PCheunsuchon PSriussadaporn S.Diabetes insipidus and panhypopituitarism as a first presentation of silent adenocarcinoma of lung: a case report and literature review. BMC Endocr Disord. 2019;19(1):114. doi:10.1186\/s12902-019-0445-5"},{"issue":"1","key":"bib13","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum","volume":"19","author":"Kassam","year":"2005","unstructured":"KassamASnydermanCHMintzAGardnerPCarrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus. 2005;19(1):E4."},{"key":"bib7","series-title":"World J Surg Oncol","first-page":"137","article-title":"Breast cancer metastatic to the pituitary gland: a case report","volume":"10","author":"Spinelli","year":"2012","unstructured":"Spinelli GPLo Russo GMiele EBreast cancer metastatic to the pituitary gland: a case report. World J Surg Oncol. 2012;10:137. doi:10.1186\/1477-7819-10-137"},{"key":"bib8","series-title":"Endocrinol Diabetes Metab Case Rep","first-page":"130024","article-title":"Pituitary metastases from papillary carcinoma of thyroid: a case report and literature review","volume":"2013","author":"Chikani","year":"2013","unstructured":"Chikani VLambie DRussell A.Pituitary metastases from papillary carcinoma of thyroid: a case report and literature review. Endocrinol Diabetes Metab Case Rep. 2013;2013:130024. doi:10.1530\/EDM-13-0024"},{"issue":"9","key":"bib9","series-title":"Clin Case Rep","first-page":"e7808","article-title":"Pituitary metastasis from renal cell carcinoma presenting with significant hyperprolactinemia, case report","volume":"11","author":"Mazar-Atabaki","year":"2023","unstructured":"Mazar-Atabaki AMohamadzadeh OSadrehosseini SMTabari AZeinalizadeh M.Pituitary metastasis from renal cell carcinoma presenting with significant hyperprolactinemia, case report. Clin Case Rep. 2023;11(9):e7808. doi:10.1002\/ccr3.7808"},{"issue":"5","key":"bib10","series-title":"Oncologist","first-page":"e789","article-title":"Extended survival after surgical resection for pituitary metastases: clinical features, management, and outcomes of metastatic disease to the sella","volume":"25","author":"Patel","year":"2020","unstructured":"Patel KRZheng JTabar VCohen MAGirotra M.Extended survival after surgical resection for pituitary metastases: clinical features, management, and outcomes of metastatic disease to the sella. Oncologist. 2020;25(5):e789-e797. doi:10.1634\/theoncologist.2019-0520"},{"key":"bib11","series-title":"World Neurosurg","first-page":"e684","article-title":"Contemporary treatment outcome of metastases to the pituitary gland","volume":"172","author":"Hong","year":"2023","unstructured":"Hong SAtkinson JLErickson DContemporary treatment outcome of metastases to the pituitary gland. 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