Pituitary metastasis from lung adenocarcinoma: A case report

Table 1 Endocrine examination result

Hormone	Level measured	Normal level
ACTH (pg/mL)	17.20	7.2-63.3
PRL (high) (ng/mL)	> 200	2.18-26.53
GH (ng/mL)	0.32	0.02-4.77
TSH (μIU/mL)	1.987	0.35-4.94
T3 (nmol/L)	1.69	0.89-2.44
TT4 (low) (nmol/L)	61.22	62.70-150.80
FT3 (pmol/L)	4.26	2.43-6.01
FT4 (pmol/L)	9.96	9.00-19.00
Tg (ng/mL)	9.988	0.20-70.00
LH (low) (pmol/L)	0.03	5.16-61.99
FSH (low) (mIU/mL)	1.08	26.72-133.41
E2 (pg/mL)	< 10	< 10-28
P4 (ng/mL)	< 0.1	< 0.1-0.2
CORT (8:00) (μg/dL)	1.0	6.02-18.4
CORT (16:00) (μg/dL)	1.5	2.68-10.5
CORT (24:00) (μg/dL)	1.1	2.68-10.5
TES (pmol/L)	< 12.98	10.83-56.94

ACTH: Adrenocorticotropic hormone; PRL: Prolactin hormone; GH: Growth hormone; TSH: Thyroid stimulating hormone; T3: Triiodothyronine; TT4: Total tetraiodothyronine; FT3: Free triiodothyronine; FT4: Free tetraiodothyronine; Tg: Thyroglobulin; LH: Luteinizing hormone; FSH: Follicle stimulating hormone; E2: Estrogen hormone; P4: Progestational hormone; CORT: Cortisol; TES: Testosterone.

Table 2 Somatic gene mutations

Gene	Expressed region	Nucleotide	Amino acid	Mutation abundance (%)
TSC2	Exon 36	c.4585C>T	p.R1529W	5.1
POLD1	Exon19	c.2312C>T	p.A771V	3.8
ARID1A	Exon 1	c.1058C>T	p.A353V	5.1
ARID1A	Exon 1	c.308C>T	p.S103L	7.7
CTNNB1	Exon 4	c.79G>A	p.G27R	13.5
ERBB2	Exon 23	c.2339C>T	p.A800V	5.1

Table 3 Summary of previously reported cases of pituitary metastasis from lung adenocarcinoma

Ref.	Year	Age (yr)	Sex	Symptom	Hormone	Treatment	Tumor Supply	Survival
Asim and Elashaal[13]	2023	54	F	None	ACTH (low), COTR (low), LH (low), FSH (low), TES (low), TSH (low), FT3 (low), FT4 (low)	RT, ST	ND	Alive, 3 months
Amaral et al[14]	2022	43	M	Headache, VFD	ACTH (low), CORT (low), FSH (low), FT4 (low), TES (low), LH (low)	ST, CT, RT, IT	R	Alive, 15 months
Wong et al[15]	2022	53	F	VFD	ND	ST, RT, CT	ND	Alive, 24 months
Han et al[16]	2022	48	F	Headache, DI	ACTH (low), Cort (low), PRL (high)	ST, CT	ND	Alive, 20 months
Lopes et al[17]	2021	62	F	Fatigue, Headache, Nocturia, Polydipsia, BV	FT4 (low), CORT (low), ACTH (low), FSH (low), PRL (high)	ST, CT	R	Alive, 24 months
Tanaka et al[9]	2021	80	F	Polyuria, Polydipsia	ADH (low)	RT, CT	ND	Alive, 7 months
Liu et al[3]	2021	53	M	BV, DI, VFD, Polyuria, Vomit, Fatigue	CORT (low), TSH (high), T4 (low), FSH (low), LH (low), PRL (high)	ST	R	Dead, 4 months
Watanabe et al[18]	2020	70	M	Anorexia	ADH (low), ACTH (low), CORT (low), FSH (low), LH (low), TSH (low)	RT, CT	ND	Dead, 5 months
Rajakumar et al[19]	2020	49	F	Headache, VFD	LH (low), FSH (low), CORT (low), TES (low), FT4 (low)	ST, RT, CT	NR	ND
Alhashem et al[11]	2020	54	M	Headache, Droop bilateral eyelid	ND	ST	NR	ND
Sheahan et al[5]	2020	52	F	MB	ACTH (low), CORT (low), FSH (low), TSH (low), PRL (high)	ST, CT	ND	ND
Yao et al[20]	2019	67	M	Headache, Vomit, ptosis	PRL (high), FSH (low), LH (low), ACTH (low), Cort (low)	ST, RT	ND	Dead, 3 months
Sirinvaravong et al[21]	2019	72	F	DI	PRL (high), FSH (low), LH (low), TSH (high)	ST	ND	Dead, 4 months
Gulati et al[12]	2015	47	F	Headache, DI	TSH (low), FSH (low)	ST	ND	ND
Arai et al[22]	2010	61	F	VFD	Normal	ST, RT	NR	Alive, 3 months

F: Female; M: Male; R: Rich; CSI: Cavernous sinus invasion; VFD: Visual field defect; ND: Not described; NR: Not rich; BV: Blurred vision; MB: Monocular blindness; DI: Dizziness; ACTH: Adrenocorticotropic hormone; ADH: Vasopressin; CORT: Cortisol hormone; PRL: Prolactin hormone; TSH: Thyroid stimulating hormone; FT3: Free triiodothyronine; FT4: Free tetraiodothyronine; LH: Luteinizing hormone; FSH: Follicle stimulating hormone; Cort: Cortisol; TES: Testosterone; ST: Surgery treatment; CT: Chemotherapy; IT: Immunotherapy; RT: Radiotherapy.