What cancers can cause pituitary stalk thickening?
Possible neoplastic etiologies of abnormal pituitary stalk thickening are multiple and include:
1. Craniopharyngiomas
2. Posterior pituitary tumors—pituicytomas, spindle cell oncocytomas, ependymomas
3. Neuronal/paraneuronal tumors—gangliocytomas, neurocytomas, paragangliomas, neuroblastomas
4. Germ cell tumors—germinomas, mixed germ-cell tumors, nongerminomatous tumors
5. Metastatic cancers—most commonly lung or breast primary cancers
In conjunction with clinical context (e.g., age, clinical presentation) and biochemical evaluation, the tumor characteristics on MRI (size, sellar/suprasellar extension; cystic components; contrast enhancement; intraparenchymal, leptomeningeal, and/or pineal gland involvement) may help narrow the diagnosis.
Diagnostic uncertainly is less likely with metastatic tumors to the pituitary gland, as patients usually have widespread cancer at the time of diagnosis.
