A giant carotid aneurysm with intrasellar extension: a rare cause of panhypopituitarism

Seok, Hannah; Park, Haneul; Kim, Gyo-Hui; Son, Hyun Shik; Sohn, Tae Seo

doi:10.3904/kjim.2015.30.2.265

Cited by 5 publications

(4 citation statements)

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“…Giant internal carotid artery aneurysms sometimes mimic pituitary tumors, and recent imaging techniques, such as flow-related effects on standard MR angiography, have proven useful for the diagnosis of intrasellar aneurysms (7,8). Giant intrasellar aneurysms may rarely cause pituitary dysfunction, resulting in adrenal insufficiency (9).…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Hypopituitarism Caused by Intrasellar Aneurysm

et al. 2020

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Giant internal carotid artery aneurysms sometimes extend into the sellar region, which rarely but occasionally results in hypopituitarism due to the compression of the normal pituitary gland or hypothalamus. Hyponatremia is a known complication of hypopituitarism. We herein report two cases of hypopituitarism caused by intrasellar aneurysm of different origins, resulting in hyponatremia. Untreated hypopituitarism may lead to lethargy, coma, cardiac arrhythmia, and death. Therefore, we must be alert for the occurrence of giant intrasellar aneurysm, as it causes hypopituitarism. The prompt diagnosis and treatment of hypopituitarism are necessary to prevent this fatal outcome.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Hypopituitarism Caused by Intrasellar Aneurysm

et al. 2020

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“…Similar hormonal findings have also been reported by Seok and cols. ( 15 ) in a patient who developed panhypopituitarism with mild hyperprolactinemia due to a giant ICA aneurysm with intrasellar extension; also, in this case, the origin of the aneurysm was unclear. This patient presented with hyponatremia and general weakness, as our patient did, but also had headache, as in some of the cases previously reported by other authors.…”

Section: Discussionmentioning

confidence: 78%

An unusual presentation of hypopituitarism caused by a sellar aneurysm

Ičin,

Stepanović,

Bajkin

et al. 2024

Archives of Endocrinology and Metabolism

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SUMMARY Hypopituitarism is a rare clinical condition that can present as a partial or complete absence of pituitary hormones. Hypopituitarism is most commonly caused by a sellar or parasellar mass, particularly a tumor, and the gold standard for its differential diagnosis is magnetic resonance imaging (MRI). Intrasellar aneurysm is an unusual cause of hypopituitarism. Indeed, about 0.17% of all cases of hypopituitarism are due to intrasellar aneurysms. We report the case of a 72-year-old man who was admitted to the hospital due to gastrointestinal symptoms and malnourishment. Due to persistent hyponatremia and spontaneous hypoglycemia in laboratory findings, the examination of the hypothalamic-pituitary-adrenal axis was eventually initiated, and the patient was later diagnosed with an unruptured aneurysm of the ophthalmic segment of the right internal carotid artery with sellar extension as a cause of panhypopituitarism. A combined endovascular treatment was performed with stent-assisted coil embolization of the aneurysm, and the patient was prescribed oral hormonal therapy. At the 1-year follow-up visit, no improvement in pituitary function was observed, and a pituitary MRI showed complete aneurysm occlusion and partial empty sella with significantly decreased pituitary volume. Aneurysms of the internal carotid artery are rare and may be associated with hypopituitarism and delayed diagnosis due to their unusual clinical presentation. Endovascular procedures, such as coil embolization of the aneurysm, could be the treatment of choice in these patients. Persistent hypopituitarism may occur even after successful treatment of the aneurysm.

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“… 3 – 5 Through a PubMed-based literature search, we could identify 34 further case reports and case series of hypopituitarism associated with unruptured intracranial aneurysms. 6 – 39 In only one of these cases, hypopituitarism occurred after treatment. 32 …”

Section: Introductionmentioning

confidence: 98%

Persistent hyperprolactinemia, transient hypopituitarism, and transient contralateral third nerve palsy after endovascular treatment of an internal carotid artery aneurysm: Case report and review of the literature

Wende

Hamerla

Quäschling

et al. 2020

SAGE Open Medical Case Reports

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Intracranial aneurysms have an estimated prevalence of about 3%. A rare subgroup are aneurysms of the internal carotid artery that develop medially into the sellar region. Due to the risk of rupture with subsequent subarachnoid hemorrhage and of compression of surrounding structures, mechanical occlusion is advised. Hypopituitarism is not a rare disease and most often related to pituitary adenoma. Only 0.17% of cases with hypopituitarism are caused by unruptured intracranial aneurysms. Today, the predominant treatment of these aneurysms is endovascular coiling or application of flow diverting stents. We present the case of a 60-year-old female patient, who was treated with endovascular coiling for a right-sided, intracavernous, incidental internal carotid artery aneurysm. On postinterventional day 6, she was readmitted with contralateral third nerve palsy, mild hyponatremia und thyreotropic insufficiency. The symptoms recovered after anti-edematous treatment with corticosteroids; only an asymptomatic hyperprolactinemia persisted. To the best of our knowledge, this is the first case report of transient contralateral cranial nerve palsy combined with transient hypopituitarism after endovascular treatment of an internal carotid aneurysm. As treatment we propose corticosteroids, if necessary in combination with nonsteroidal anti-inflammatory drugs, in order to inhibit inflammatory reactions of the aneurysm wall compromising the nearby, partially compressed neural structures.

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A giant carotid aneurysm with intrasellar extension: a rare cause of panhypopituitarism

Cited by 5 publications

References 0 publications

Two Cases of Hypopituitarism Caused by Intrasellar Aneurysm

Two Cases of Hypopituitarism Caused by Intrasellar Aneurysm

An unusual presentation of hypopituitarism caused by a sellar aneurysm

Persistent hyperprolactinemia, transient hypopituitarism, and transient contralateral third nerve palsy after endovascular treatment of an internal carotid artery aneurysm: Case report and review of the literature

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