Metastasis of a small cell carcinoma from undetected origin to the pituitary gland--the otolaryngologist's view.

Tumour metastasis to the anterior pituitary-hypothalamic area is rare. We present a patient who had severe headache, bitemporal quadrant hemianopsia and an expanding mass in the sella turcica as revealed by MRI. Partial resection via a transsphenoidal approach was performed and postoperative radiation therapy was initiated. Immunohistochemical investigation identified the tumour as a metastatic small cell carcinoma whose primary site remained undetected for more than 12 months despite repeated oncological evaluations. We reviewed the literature on metastatic disease of the pituitary gland.

Fungus-like sinusitis.

Fungus-like sinusitis is also called eosinophilic mucin rhinosinusitis (EMRS). This terminology is purely descriptive and refers to a rhinosinusitis, whose clinical presentation and imaging are similar to those of a noninvasive fungal sinusitis but in which fungus could not be demonstrated pathologically using the conventional silver staining technique or on culture. The authors report 2 clinical cases and recall the diagnostic criteria for the different forms of fungal sinusitis in immunocompetent patients.