The tale of two tumours: an undiagnosed case of papillary thyroid carcinoma

Pituitary metastasis is an infrequent clinical problem occurring in 1%–5% of various autopsy series. Differentiated thyroid carcinoma as the primary malignancy was reported in only 2.1% of the cases. A 53-year-old Filipina presented with 7 months history of progressive loss of vision and headaches. She underwent thyroidectomy 2 years prior to admission for an enlarging neck mass. After then, she was lost to follow-up. Physical examination revealed visual field loss, galactorrhea and a 3×4 cm firm suprasternal mass. Imaging showed a 4.5×5×5 cm mass in the sphenoid and ethmoid sinuses with extension into the sella and suprasellar regions. Biopsy of the mass was consistent with papillary thyroid carcinoma, metastatic. For that, she underwent completion thyroidectomy, followed by surgical debulking of the sellar mass. Postoperatively, there was minimal improvement in vision and 13 months after, she is still on constant follow-up in our clinic, and is due for radioiodine therapy.