Stalking the diagnosis

...This case illustrates an unusual presentation of breast cancer — that is, metastasis to the pituitary gland. In retrospect, the patient presented with a number of typical symptoms and signs of hypopituitarism, including weakness, intermittent nausea, orthostasis, polydipsia, and polyuria. Her fever and positive urine culture, as well as her dysphagia and dry mouth, initially distracted the clinicians from a consideration of the primary disease process. The recognition of the hormonal deficiencies caused by a lesion on the pituitary stalk and the reconciliation of these developments with the diffuse lymphadenopathy led to the definitive diagnosis that unified this seemingly incongruent set of clinical findings.
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