1 case of pituitary metastasis of liver cancer.

The incidence of brain metastasis cancer in the frontal lobe and the pituitary pituitary metastasis is very rare, which accounts for only intracranial metastasis malignanciesClinical manifestations similar to the rest of the tumors in the saddle area imaging performance is variable and atypical characteristics, so it is very easy to misdiagnoseAnd from liver cell cancer ( ) pituitary metastasis more rare and other cases of pituitary metastasis retrospective analysis of liver cell source current literature reported liver cancer metastasis and pituitary body cases reported in total casesNow will be my hospital treatment case of hepatic epithelial-like vascular cell tumor pituitary metastasis patients reported as follows: medical records of the patient male age due to the progressive decline of left eye vision admitted to the hospital with the right liver leaf occupaic lesions (figure) postoperative pathology test for patients with hepatic epithelial hemangioma due to the appearance of double vision to blindness and then admitted to our hospitalCheck body: the mind clearly check the body under cooperative double-sided pupils and other large such circle diameter to the disappearance of light reflection can not distinguish between light and darkness and the immediate manualPreoperative hormone testing is as follows: adrenal corticosteroids; prolactin; thyroid-stimulating hormone; thyroxine; triiody thyroxine; and growth hormone testresults are normalThe magnetic resonance imaging () of the saddle area before the year-on-year surgery suggests that an uneven lump can be seen in the saddle and expands on the saddle to a peanut-like size of about xPreoperative diagnosis of pituitary tumors (see figure)In the year-long whole hemp down the nasal endoscopic pituitary tumor excision surgery see the saddle tumor texture ligament rich to be removed part of the tumor in the saddle after seeing the tumor breakthrough saddle perforation into the saddle tumor decompression see the tumor and the double-sided optic nerve, cervical artery and hypothalamus adhesion close lysathing tumor and cervical artery adhesion tight lysa can not separate the tumor to be conventionally reconstructedPostoperative review (pictured) did not see the obvious bleeding after the pathological photoscopy seen: tumor cell shuttle-shaped flaky distribution cell volume large plasma rich, red-dyed nucleo-egg circular nucleus clear nucleus division is easy to see scattered in the middle of a small tumor cytomegalo(see figure)Immunohistification: (-) ;();(-;();();();(); Pathological diagnosis is: (saddle area) malignant inter-leaf differentiation of tumors consider metastatic epithelial-like vascular smoothfibromyoma can not be excludedPatients with postoperative fever cerebrospinal fluid cell number of lumbar tube cerebrospinal fluid continuous drainage and antibiotic combination treatment days to review cerebrospinal fluid white blood cells reduced to the protein dropped to no further fever after the weekly discharge from the hospital patients with mental non-abnormal vision was not restoredDiscussion Although the pituitary as a rare metastasis of malignant tumors, and other summary cases of pituitary metastatic cancer of the primary lesions found that almost all tumors can be through arterial blood, gate vein system, saddle pool metastasis and cranial bottom directly spread to the pituitary, where the breast, lung, respectively, the more common liver accounted for a certain proportion of patients finally can not find the original case of the case of the case of the metastasis epithelicarda () source of epithelial hemangioidoma () A metastatic congiopthemic tumor with metastasis was originally thought to be an intermediate endothelioma but in the annual classification epithelial-like endothelioma has been classified as a low-level malignant angiosarcomaThe local recurrence rate occurred in the soft organizers was one of the metastasis of hepatic epithelial-like endothelioma ,which was about multi-transfer to the lungs, abdominal lymph nodes, retina and bone, but extremely rareThe diagnosis of pituitary metastasis is more difficult and good hair age is no significant statistical difference between men and women aged all tumors can occur pituitary metastasis in elderly male patients with large secondary reproductive cell tumor syllas with lung cancer metastasis most common female patients with breast cancer metastasis the most common routes of breast cancer metastasis include: through blood to the predibique prefrontal leaves, first to the pituitary handle and then spread to the normal pituituding, first to the structure around the pituitary gland such as butterfly saddle area, slope, slope, slope The clinical symptoms of spongiform sinus spread to the pituitary gland and transfer to the pituitary gland through the soft meninges are mainly urinary collapse, eye muscle movement impairment, vision loss, low drooping function, headache, etcMetastatic pituitary tumors are prone to early tiredness and saddle-riding across the saddle are dumbbell-shaped; tumor invasive often invades the saddle sponge sinuses leading to cranial nerve dysfunctionIn this case, there was no urinary collapse in patients with no preoperative urinary collapse after the vision loss pituitary gland caused by pressure on the optic nerve Early diagnosis of metastatic pituitary tumors mainly relied on the lack of characteristics of pituitary metastatic tumors that did not accompany other parts of the skull, which were often enhanced uniformly or unevenly by the addition of iso-density or slightly high-density saddle shadow enhancement The saddle lesions that appear as isometric signals or slightly lower signals high in the saddle area can be reinforced uniformly or unevenly after enhancement Some studies have shown that metastatic pituitary tumors may exhibit characteristic manifestations: the lumps in the pituitary body appear as dumbbells, and the pituitary shank shrank when the pituitary handle is shifted to significantly enhance the performance of this case in line with the study Many pituitary metastatic tumors are found and identified in surgery and whose definitive diagnosis needs to rely on pathology Treatment of pituitary metastatic tumors includes surgery, radiotherapy, chemotherapy, hormone-targeted drug therapy, and molecular-targeted therapy Surgery to determine diagnosis and remission symptoms is the main target of the lesions located in the saddle area surgery preferred endoscopy or microscope through nasal surgery The sterile operation of the pituitary tumor excision surgery of the sinus butterfly path is disabled, the risk of death is high and the nasal butterfly sinus itself is in a polluted state, so the sterile operation in the operation must be strictly strengthened This report was performed by nasal butterfly neuroendoscopy With the development of neuroendoscopic technology, the removal of such saddle tumors by the nasal endoscopy has gradually become the preferred mode of surgery with its unique advantages The nerve endoscopy through the natural nasal passage into the butterfly sinus without cutting the nasal mucosa This minor nasal cavity trauma does not affect the nasal appearance of the post-operative nasal field of vision to facilitate tumor removal in the saddle and saddle compared to the microscope technology wider vision of the wider endoscope lens flexibility higher accuracy and even can identify the two-sided optic nerve tube, neck artery bulge and saddle depression can effectively remove the sinus pitual tumor that occurs on both sides of the butterfly saddle to resolve the limitations of the microscope But the neural endoscopy also has the disadvantage of endoscopy although the effect is good but the mirror two-dimensional image stereoscopic sense is poor and the operator needs a one-hand mirror difficulty big endoscope need stoic internal need stoic easily contaminated mucus need to withdraw cleaning is not conducive to sudden bleeding state hemorrhage with the development of the author believes that the above problems will be gradually resolved Surgery can clearly diagnose and alleviate the symptoms of patients but can not prolong the life cycle with tumor radiotherapy, chemotherapy, hormone-targeted drug therapy and molecular-targeted therapy and other complementary treatment syllthamens significantly longer The prognosis of pituitary metastatic tumors depends on the degree of malignancy of primary tumors Generally pre-prognosticafter the average survival time after months of simple tumor transfer to pituitary patients with more long survival time Related literature reports the longest survival time is years In this case, the patient followed the lungs monthafter after surgery to see the metastatic exophdectomy of the exophdaryl stoice in the current treatment