Pituitary metastasis presenting with visual loss and Foster–Kennedy syndrome: Case report and review of literature

Foster–Kennedy syndrome (FKS) is often associated with intracranial pathologies in the anterior cranial fossa. Herein, we describe an unusual case of pituitary metastasis presenting as FKS and severe visual loss with a relevant literature review. A 54-year-old woman presented with severe bilateral vision loss. She had been previously treated for metastatic thyroid cancer. At presentation, her fundus findings revealed a variant of FKS and right-eye sixth cranial nerve paresis. On the basis of the temporal visual field defect in the confrontation visual fields, we insisted on repeat neuroimaging. Magnetic resonance imaging revealed compressive lesions in the sellar and occipital areas. Histopathology confirmed thyroid cancer metastasis to the pituitary gland, which was managed with radiotherapy. Partial but useful vision could only be restored in the right eye. Chiasmal compression due to pituitary metastasis is an uncommon cause of visual loss in a known case of cancer.