Pituitary function after pituitary apoplexy

Pelkonen, Risto; Kuusisto, A. N.; Salmi, Jorma; Eistola, Pentti; Raitta, Christina; Karonen, Sirkka-Liisa; Aro, Antti

doi:10.1016/0002-9343(78)90795-7

Cited by 87 publications

(48 citation statements)

References 29 publications

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“…Spontaneous remission of acromegaly following apoplexy has been reported in more than 20 cases [5][6][7][8][9][10][11][12]. Most of them were reported in the pre-MRI era, were associated with hypopituitarism, and were treated conservatively.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery may also improve pituitary function [18]. Recently, however, many cases showing spontaneous recovery with satisfactory results after conservative treatment have been reported [7,9,19]. In case of functioning adenomas with complete remission of endocrinopathy following apoplexy, surgical intervention may be unnecessary when definitive diagnosis could be obtained without histological verification.…”

Section: Discussionmentioning

confidence: 99%

“…When apoplexy arises in functioning adenomas, it may result in spontaneous remission of symptoms by reduction of hypersecreted pituitary hormones usually with hypopituitarism. Cases with remission of acromegaly have been most frequently reported [5][6][7][8][9][10][11][12], whereas prolactinoma cases with remission of amenorrhea have been rarely reported [13]. Diagnosis of apoplexy without massive hemorrhage is often difficult since no specific CT or MRI findings of infarction have been reported [1,14,15], and the indications of surgery remain controversial [1].…”

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confidence: 99%

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Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

2005

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Abstract. Functioning pituitary adenomas may exhibit spontaneous remission after pituitary apoplexy usually in association with hypopituitarism. We report two patients who presented with sudden headache and double vision, showed a ring-enhanced sellar tumor on MRI, underwent transsphenoidal surgery that revealed a coagulation necrotic adenoma without massive hemorrhage, and showed normal pituitary function after the surgery. Definitive diagnoses were made based on immunohistochemistry of the necrotic cells. The findings were consistent with the presence of selective infarct of a GH adenoma and a prolactinoma that had led to remission of acromegaly and menstrual disturbance, respectively, without pituitary insufficiency. In contrast to hemorrhagic apoplexy, infarctive apoplexy tends to affect only the tumor and thus presents with mild symptoms and lack pituitary deficiencies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

2005

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“…The secondary adrenal failure recovered dramatically after glucocorticoid replacement. Acute adrenal crisis due to loss of adrenocorticotropic hormone is the most lifethreatening endocrine disorder which is detected in two thirds of the patients with PA [15]. Thus, glucocoticoids should be given empirically in all cases of suspected PA.…”

Section: Discussionmentioning

confidence: 99%

Complete Surgical Resolution of Bilateral Total Opthalmoplegia without Visual Field Defect in an Acromegalic Patient Presented with Pituitary Apoplexy

et al. 2007

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Abstract. Pituitary apoplexy (PA), which is one of the most serious life-threatening complications of pituitary adenoma, is characterized by abrupt onset of headache, nausea, vomiting, visual disturbances and oculomotor paresis. Combination of oculomotor cranial nerve paralysis with normal visual fields is very rare in PA. We report a 60-year-old acromegalic man presented with panhypopituitarism and bilateral total opthalmoplegia without a visual field defect. At initial evaluation his clinical findings were compatible with adrenal crisis and eye examination revealed total opthalmoplegia, bilateral ptosis and normal vision. MRI showed a large heterogeneous mass in the pituitary fossa. Although clinical findings due to adrenal crisis improved after glucocorticoid therapy there was no improvement in opthalmoplegia and ptosis. The patient underwent transsphenoidal excision of the pituitary mass. Histological examination revealed an adenoma with large areas of hemorrhagic infarction and most of the cells were positive for GH in immunohistochemical analysis. Although opthalmoplegia was severe at presentation, total recovery was achieved 3 months after transsphenoidal surgery. Therefore the presented case clearly demonstrates that opthalmoplegia without a visual field defect due to PA has a good prognosis and early diagnosis and treatment including surgical decompression are crucially important.

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“…Several investigators have studied the anterior pituitary function in patients with pituitary adenoma secreting adrenocorticotropin after an episode of pituitary apoplexy and have reported severe deficiency of adrenocorticotropin in most such patients [6][7][8] . Our patient with pituitary apoplexy differed from these cases since she had only a reduction in GH secretion, while her other anterior pituitary functions remained intact.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Cushing's Disease after Long-term Remission due to Pituitary Apoplexy.

et al. 2000

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Pituitary function after pituitary apoplexy

Cited by 87 publications

References 29 publications

Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

Complete Surgical Resolution of Bilateral Total Opthalmoplegia without Visual Field Defect in an Acromegalic Patient Presented with Pituitary Apoplexy

Recurrence of Cushing's Disease after Long-term Remission due to Pituitary Apoplexy.

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