关键词: 垂体肿瘤, 尿崩症, 疾病特征, 诊断

Abstract: Objective　To analyze the clinical characteristics of pituitary metastasis（PM） with diabetes insipidus as the initial manifestation，so as to improve clinicians' capabilities in the differential diagnosis of this disease from diabetes insipidus，avoiding the incidence of misdiagnosis and missed diagnosis.Methods　In November 2016，one male patient was admitted to Department of Endocrinology，the First Affiliated Hospital of Anhui Medical University due to pituitary metastasis from lung cancer with diabetes insipidus as the initial manifestation.Meanwhile，using the search terms（“pituitar*/hypophys*” “metasta*” combined with “diabetes insipidus” or “垂体” “转移” combined with“尿崩症”），we searched PubMed，ISI Web of Knowledge，CNKI，and Wanfang Data Knowledge Service Platform for studies about PM with diabetes insipidus as the initial manifestation published between January 1990 and October 2017.We conducted a retrospective analysis of the clinical data of the cases involved in the included studies and the male case treated by us.Results　Thirty-one articles were included，involving 41 cases.So totaled 42 cases enrolled after adding our case，and the data of them were summarized as follows：distribution of sex：24 males and 18 females；mean age：（56.6±12.7） years old；primary disease：malignant tumor；diagnostic pathway：41 patients by pathological examination，the other 1 by the combination of chest CT and serum tumor markers；main clinical manifestations：polyuria，polydipsia，and headache；imaging findings：lesions in sellar region were identified in 41 cases，and the tumor had metastasized to more than 2 sites in 29 cases；laboratory findings：insufficient secretion of hormone in the anterior pituitary was found in 26 cases，and electrolyte disorders in 11 cases；outcome：all showed poor outcome，with a median survival time of 6.0 months，1-year cumulative survival rate of 22.1%，and 3-year cumulative survival rate of 17.7%.Conclusion　PM is a rare tumor-related complication with poor prognosis.Diabetes insipidus could be the initial manifestation and even the only symptom of these patients.Therefore，for a middle-aged or elderly patient with new-onset diabetes insipidus，diagnosis should be performed based on identifying the primary disease，and considering the effect of systemic disease as well as PM.

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