Apoplexy in a corticotrophin-secreting pituitary macroadenoma: a case report and review of the literature

Cushing’s disease presenting with pituitary apoplexy

“…We identified 16 patients and their clinical course is summarised in Supplementary Tables 2-4. [11][12][13][14][15][16][17][18][19][20][21][22][23] A female predominance was observed among these patients with ACTH-producing pituitary tumour apoplexy (11 out of 17) compared to a male predominance for pituitary apoplexy in general, 24 possibly because of a female preponderance for Cushing's disease. The average age of clinical onset was 39.4 years compared to slightly later age group for other pituitary apoplexy, which is known to occur at an average age of 50.9 years.…”

Evaluation of the Sellar and Parasellar Regions

“…The sella may appear normal, show an isodense/ hypodense sellar mass, 44,45 or show a hyperdense mass as a result of hemorrhage. 46,47 If imaging is obtained days or weeks after symptom onset, it is difficult to differentiate between necrosis, remote hemorrhage, or bland infarction. 48 Although most case reports or series do not include postcontrast imaging, there can be nonenhancement 49,50 or inhomogeneous heterogeneous enhancement, 51 often attributed to an underlying adenoma.…”

Morphological feature of haemorrhages into pituitary adenomas

“…Риск увеличения объема опухоли (не кровоизлияния) достигает 14% для микроаденом и 30% для макроаденом за 1,8-6,7 лет [7][8][9]. Размер половины макроаденом увеличивается в среднем на 10% за 32 месяца [10]. Риск кровоизлияния в опухоль гипофиза составляет от 0,4 до 7% за период от 2 до 6 лет [7,11,12] и может достигать 9,5% за 5 лет [10].…”

“…Размер половины макроаденом увеличивается в среднем на 10% за 32 месяца [10]. Риск кровоизлияния в опухоль гипофиза составляет от 0,4 до 7% за период от 2 до 6 лет [7,11,12] и может достигать 9,5% за 5 лет [10]. В 80% случаев кровоизлияние в аденому гипофиза -первое проявление заболевания [13,14].…”