A Rare Case of Early and Isolated Breast Cancer Metastasis to the Pituitary: A Case Report and Systematic Review
Bibliographic record
Abstract
Objective: We present a systematic review of pituitary metastasis (PM) arising from breast cancer, and a rare case that was detected shortly after initial diagnosis of invasive ductal carcinoma. Two years following breast cancer diagnosis, the patient presented with complaints of headache and polydipsia. Systemic workup was unremarkable, but brain imaging identified an isolated metastatic lesion in the pituitary gland. Surgery was performed via transsphenoidal approach, and the patient underwent RT targeted to the sellar region. Unfortunately, she passed away 9 months later from systemic progression. We present a systematic review highlighting presentation, treatment strategy, and outcomes of breast cancer metastasis to the pituitary gland. Methods: Case reports and series pertaining to breast cancer metastasis to the pituitary gland were included in the analysis. Only histologically confirmed cases of breast cancer PM were included. Results: A total of 34 patients (including the patient presented in our case) were included in the analysis. PM was diagnosed at a mean of 60 months from initial breast cancer diagnosis. Prevalent signs/symptoms included visual disturbance, diabetes insipidus (DI), and hypothalamic dysfunction. Patients treated with surgical resection and adjuvant chemotherapy, or radiotherapy had better survival than those treated with resection alone. Conclusion: Breast cancer metastasis to the pituitary often presents without localizing features. Our results show that patients who receive treatment for isolated PM may survive for many years without progression or recurrence, and support the use of adjuvant RT and ChT for prolonged survival following surgical resection. Publication History Article published online: 15 February 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".