Purpose: To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors.
Methods: Clinical presentation of our series of cases. Contemporary published literature is also reviewed.
Results: The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma.
Conclusion: Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.
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http://dx.doi.org/10.1007/s40618-015-0424-2 | DOI Listing |
Cureus
December 2024
Department of Neurosurgery, NMC Royal Hospital, Abu Dhabi, ARE.
Patients presenting with acute onset of headache and ophthalmoplegia are clinically diagnosed as having a pituitary adenoma with apoplexy. Rarely, other diseases can mimic this condition clinically and radiologically, requiring a high index of suspicion to reach the correct diagnosis. We present a case of a 37-year-old male of Indian origin, who had intra- and supra-sellar tuberculosis (TB), presenting with classical clinical features of pituitary apoplexy and constitutional symptoms.
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Neurosurgery Westchester Medical Center, Valhalla, New York, United States.
Background: Pituitary apoplexy (PA) is a rare, life-threatening clinical syndrome that occurs in response to acute ischemic infarction or hemorrhage of a pituitary adenoma. We report two cases of sudden neurologic and visual decline in patients with pituitary region masses in coronavirus disease (COVID)-positive patients with a focus on potential pathophysiological mechanisms and a safe approach to treatment.
Case Description: Case one is a 58-year-old male presenting with sudden-onset headache and visual disturbance.
Pituitary
December 2024
Department of Diabetes and Endocrinology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.
Purpose: Rathke's cleft cysts (RCC) are present in up to 20% of autopsy studies but only a minority necessitate surgical treatment. Inflammation of RCC is thought to be significant in three processes: the development of classical symptoms, a predisposition to rupture or apoplexy, and increasing the rate of RCC recurrence. We aim to characterize clinical presentation, histological and radiological findings in patients with surgically managed RCC.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
December 2024
Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China.
Background: Pituitary adenomas (PAs) present with clinical features such as neuroendocrine abnormalities and mass effects, common in the general morbidity population. However, in elderly patients, the disease progression renders some clinical features difficult to detect and identify in time. Consequently, elderly patients with PAs are often not identified and receive sufficient intervention on time to achieve a satisfactory outcome.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Neurosurgery, Hannover Medical School, 30625 Hannover, Germany.
Background: Pituitary apoplexy is a potentially life-threatening condition that most often results from hemorrhage into a preexisting pituitary neuroendocrine tumor (PitNet) presenting with acute headache, visual impairment and endocrine dysfunction. Here, we aimed to identify factors associated with hemorrhage and present the pituitary hormonal status before and after transnasal-transsphenoidal tumor removal in a comparative study design.
Methods: A series of 100 patients with PitNet were analyzed.
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