Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report

No Thumbnail Available
Authors
Merchant, H.
Rye, D. S.
Smith, J. A.
Journal
The Journal of Laryngology and Otology
Type
Case Report
Publisher
Cambridge University Press
Rights
© JLO (1984) Limited, 2020
Objective: This paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma. Case report: A 64-year-old male, diagnosed with a primary p16-negative squamous cell carcinoma in the right tonsil, was treated with a course of chemoradiotherapy with curative intent. Positron emission tomography/computed tomography, performed at six months post-treatment, revealed a good local response and no distant metastases. The patient was placed on routine follow up at two-monthly intervals. Two months into follow up, he presented with a right-sided oculomotor nerve palsy and partial Horner's syndrome. Imaging and biopsy revealed a pituitary fossa metastasis (p16-negative squamous cell carcinoma), and a further positron emission tomography/computed tomography visualised this lesion. He was deemed unsuitable for further intervention and underwent palliative radiotherapy for symptom control. Conclusion: This case represents the first reported isolated pituitary fossa metastasis from a tonsillar squamous cell carcinoma. A high degree of clinical suspicion is recommended, along with a low threshold for biopsy and a cautioned use of positron emission tomography/computed tomography, when investigating such patients.
Citation
Merchant H et al. Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report. J Laryngol Otol. 2020 Apr;134(4):369-371. doi: 10.1017/S0022215120000602. Epub 2020 Apr 1.
Note
This article is available to RD&E staff via NHS OpenAthens. Click on the Publisher URL, and log in with NHS OpenAthens if prompted.