Although nasopharyngeal carcinoma(NPC)commonly invades the skull base, metastasis to the central nervous system remains an infrequent phenomenon.We report a rare case of invasive nasopharyngeal carcinoma with pituitary metastasis, initially had a diagnostic confusion as a concurrent pituitary macroadenoma.A 32-year-old woman presented with multiple left neck swellings, left eye strabismus, slurred speech, constitutional symptoms, headache, galactorrhoea, and multiple cranial nerve palsies.Nasoendoscopy revealed a slightly enlarged left torus and mild inflammation in the adenoid, with clear bilateral fossa of Rosenmüller.Biopsy from the adenoid area confirmed undifferentiated NPC.Imaging studies, including computed tomography and magnetic resonance imaging(MRI)of the brain and pituitary, revealed a left nasopharyngeal mass and an enhancing pituitary mass, involving the infundibulum and bilateral cavernous sinuses with no bone erosion.Biochemical tests showed panhypopituitarism.The patient was referred to the oncology department for treatment.Postchemotherapy MRI demonstrated normalization of the pituitary gland and stalk, suggesting previous involvement from NPC.
Gandhi et al. (Mon,) studied this question.