Hypopituitarism as the presenting feature of bronchogenic carcinoma with metastases to the pituitary gland.

Tumours metastasizing to the pituitary gland are uncommon. Symptomatic patients with pituitary metastases can present with diabetes insipidus, headache, visual field defects and/or anterior pituitary hormonal dysfunction. Treatment options for pituitary metastases include, surgical resection, cranial or parasellar irradiation and/or chemotherapy, and hormonal replacement if indicated. The overall prognosis of pituitary metastases is poor. We present a case of hypopituitarism as the presenting feature of bronchogenic carcinoma with metastases to the pituitary gland.

Using the Liverpool Care Pathway for a dying patient.

This article describes the experience of staff in one acute hospital in Northern Ireland who adapted the Liverpool Care Pathway (LCP) for the dying patient to suit their organisation. It focuses on one patient's journey, from diagnosis to terminal care. The patient remained on the care pathway for 12 days. This reflection demonstrates that, as long as patients continue to meet the criteria for the LCP, some may be on the care pathway for more than the recognised average of two days.