Post operative pituitary apoplexy in a case of giant pituitary adenoma

10.5580/44a ◽  
2009 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Giant Pituitary Adenoma

scholarly journals Ruptured aneurysm–induced pituitary apoplexy: illustrative case

2021 ◽  
Vol 1 (26) ◽  
Author(s):  
Michiharu Yoshida ◽  
Takeshi Hiu ◽  
Shiro Baba ◽  
Minoru Morikawa ◽  
Nobutaka Horie ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Magnetic Resonance ◽  
Vision Loss ◽  
Pituitary Apoplexy ◽  
Relevant Literature ◽  
Artery Aneurysm ◽  
Ruptured Aneurysm ◽  
Illustrative Case ◽  
Aneurysmal Rupture ◽  
Giant Pituitary Adenoma

BACKGROUND Pituitary apoplexy associated with aneurysmal rupture is extremely rare and may be misdiagnosed as primary pituitary adenoma apoplexy. The authors present a case of a patient with pituitary apoplexy caused by rupture of an anterior cerebral artery aneurysm embedded within a giant pituitary adenoma, and they review the relevant literature. OBSERVATIONS A 78-year-old man experienced sudden headache with progressive vision loss. Magnetic resonance imaging (MRI) revealed a giant pituitary tumor with abnormal signal intensity. Magnetic resonance angiography immediately before surgery showed a right A1 segment aneurysm, suggesting coexisting pituitary apoplexy and ruptured aneurysm. The patient underwent urgent transsphenoidal surgery for pituitary apoplexy. The tumor was partially removed, but the perianeurysmal component was left behind. Subsequent cerebral angiography showed a 5-mm right A1 aneurysm with a bleb that was successfully embolized with coils. Retrospective review of preoperative dynamic MRI showed extravasation of contrast medium from the ruptured aneurysm into the pituitary adenoma. Histopathologic examination showed gonadotroph adenoma with hemorrhagic necrosis. Postoperatively, the patient’s visual function improved. LESSONS MRI identification of pituitary apoplexy caused by aneurysmal rupture has not been reported previously. Aneurysmal rupture should be considered in the differential diagnosis of pituitary apoplexy. When a ruptured aneurysm is encountered, the authors recommend treating it before addressing pituitary apoplexy.

Evaluation of Fine Feeding System and Angioarchitecture of Giant Pituitary Adenoma

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Yoshikazu Ogawa ◽  
Kenichi Sato ◽  
Yasushi Matsumoto ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Adenoma ◽  
Feeding System ◽  
Giant Pituitary Adenoma

scholarly journals Pituitary apoplexy induced by gonadotropin-releasing hormone (GnRH) agonist administration for treatment of prostate cancer: a systematic review

2021 ◽  
Author(s):  
Rishi Raj ◽  
Ghada Elshimy ◽  
Aasems Jacob ◽  
P. V. Akhila Arya ◽  
Dileep C. Unnikrishnan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Pituitary Adenoma ◽  
Gnrh Agonist ◽  
Tumor Size ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Surgery ◽  
Laboratory Evaluation ◽  
The Mean

Abstract Objective We aimed to review of literature on the clinical presentation, management and outcomes of pituitary apoplexy following gonadotrophic release hormone (GnRH) agonist administration for the treatment of prostate cancer. Methods We used PRISMA guidelines for our systematic review and included all English language original articles on pituitary apoplexy following GnRH agonist administration among prostate cancer patients from Jan 1, 1995 to Dec 31, 2020. Data on patient demographics, prostate cancer type, Gleason score at diagnosis, history of pituitary adenoma, clinical presentation, GnRH agonist, interval to pituitary apoplexy, laboratory evaluation at admission, radiologic findings, treatment of pituitary apoplexy, time to surgery if performed, pathology findings, and clinical/hormonal outcomes were collected and analyzed. Results Twenty-one patients with pituitary apoplexy met our inclusion criteria. The mean age of patients was 70 (60–83) years. Leuprolide was the most common used GnRH agonist, used in 61.9% of patients. Median duration to symptom onset was 5 h (few minutes to 6 months). Headache was reported by all patients followed by ophthalmoplegia (85.7%) and nausea/vomiting (71.4%). Three patients had blindness at presentation. Only 8 cases reported complete anterior pituitary hormone evaluation on presentation and the most common endocrine abnormality was FSH elevation. Tumor size was described only in 15 cases and the mean tumor size was 26.26 mm (18–48 mm). Suprasellar extension was the most common imaging finding seen in 7 patients. 71.4% of patients underwent pituitary surgery, while 23.8% were managed conservatively. Interval between symptoms onset to pituitary surgery was 7 days (1–90 days). Gonadotroph adenoma was most common histopathologic finding. Clinical resolution was comparable, while endocrine outcomes were variable among patients with conservative vs surgical management. Conclusion Although the use of GnRH agonists is relatively safe, it can rarely lead to pituitary apoplexy especially in patients with pre-existing pituitary adenoma. Physicians should be aware of this complication as it can be life threatening. A multidisciplinary team approach is recommended in treating individuals with pituitary apoplexy.

Pituitary Apoplexy and Its Effect on Vision

Neurosurgery ◽  
1991 ◽  
Vol 29 (5) ◽  
pp. 669-675 ◽  
Author(s):  
Robert M. McFadzean ◽  
David Doyle ◽  
Roy Rampling ◽  
Evelyn Teasdale ◽  
Graham Teasdale
Keyword(s):  
Pituitary Adenoma ◽  
Clinical Diagnosis ◽  
Clinical Features ◽  
Visual Function ◽  
Pituitary Apoplexy ◽  
Diagnostic Errors ◽  
Large Series ◽  
Ocular Motility ◽  
Pathological Findings ◽  
Results Of Treatment

Abstract A series of 15 patients with a clinical diagnosis of pituitary apoplexy is reviewed. Clinical features are highlighted, with stress on the defects of visual function and ocular motility, and the associated endocrine abnormalities are described. Potential diagnostic errors and their significance are considered. The incidence of this complication in a large series of pituitary adenoma patients is measured, and the radiological and pathological findings are recorded. The results of treatment by surgery and/or radiotherapy and/or bromocriptine are assessed, particularly in relation to visual consequences, and compared with previous reports in the literature, which are reviewed.

Giant Pituitary Adenoma Manifesting As Homonymous Hemianopia

2007 ◽  
Vol 51 (2) ◽  
pp. 151-153 ◽  
Author(s):  
Masashi Nishimura ◽  
Takuji Kurimoto ◽  
Yoshitaka Yamagata ◽  
Hideyasu Ikemoto ◽  
Norio Arita ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Homonymous Hemianopia ◽  
Giant Pituitary Adenoma

scholarly journals An unrecognized endocrinology emergency masquerading as a hypertensive emergency: A can’t miss diagnosis

2016 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Yanerys Agosto Vargas ◽  
Sharon Velez Maymi ◽  
Paola Mansilla Letelier ◽  
Luis Raul Hernandez-Vazquez ◽  
Samayra Miranda Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Mortality Rate ◽  
Pituitary Gland ◽  
Pituitary Apoplexy ◽  
Systemic Hypertension ◽  
Pituitary Macroadenoma ◽  
Rare Entity ◽  
Factors Associated ◽  
Multiple Risk Factors

Pituitary apoplexy secondary to sellar tumors is a rare entity that carries a high mortality rate. It could be secondary to infarction or hemorrhage of the pituitary gland. The incidence remains unclear, most are reported in men between the ages of 50 to 60. In the majority of times, apoplexy is idiopathic in nature, without a clear discernible cause. However, there are multiple risk factors associated with this entity, such as systemic hypertension, among others. There are few cases of pituitary apoplexy caused by infarction of a pituitary macroadenoma. We present this case of pituitary apoplexy secondary to infarction of a nonfunctional pituitary adenoma in a young woman, with a fortunate resolution.

Neurosurgical image: giant pituitary adenoma and multiple aneurysms

2018 ◽  
Vol 33 (3) ◽  
pp. 312-314
Author(s):  
Himanshu Agarwal ◽  
Chandril Chugh ◽  
Saraj Singh ◽  
Prakash Singh
Keyword(s):  
Pituitary Adenoma ◽  
Giant Pituitary Adenoma ◽  
Multiple Aneurysms
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