open access

Vol 64, No 1 (2013)
Case report
Published online: 2013-02-28
Submitted: 2013-05-14
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Spontaneous regression of non-functioning pituitary adenoma due to pituitary apoplexy following anticoagulation treatment — a case report and review of the literature

Grzegorz Zieliński, Przemysław Witek, Andrzej Koziarski, Jan Podgórski
Endokrynologia Polska 2013;64(1):54-58.

open access

Vol 64, No 1 (2013)
Case report
Published online: 2013-02-28
Submitted: 2013-05-14

Abstract

Pituitary apoplexy (PA) is a rare, potentially life-threatening medical condition due to acute ischaemia or haemorrhage of the pituitary gland. The main clinical features are: abrupt onset of severe headache, nausea, vomiting, deteriorating level of consciousness, visual impairment and/or endocrine deficiency. Correct and prompt diagnosis is essential for effective therapy, but there are no randomised studies or strict recommendations defining treatment modalities. We present the case of a 59 year-old woman with pituitary tumour apoplexy, presenting with severe headache, vomiting and visual field deterioration. The patient was treated conservatively because of her refusal of surgery and was followed-up for five years. In the course of treatment, recovery of the visual field defects, as well as right sixth cranial nerve paresis, was observed. Repeated magnetic resonance imaging (MRI) revealed regression of the tumour without signs of its re-growth. We discuss therapeutic modalities with particular emphasis on morbidity and review the literature relating to the management of pituitary tumour apoplexy.

Abstract

Pituitary apoplexy (PA) is a rare, potentially life-threatening medical condition due to acute ischaemia or haemorrhage of the pituitary gland. The main clinical features are: abrupt onset of severe headache, nausea, vomiting, deteriorating level of consciousness, visual impairment and/or endocrine deficiency. Correct and prompt diagnosis is essential for effective therapy, but there are no randomised studies or strict recommendations defining treatment modalities. We present the case of a 59 year-old woman with pituitary tumour apoplexy, presenting with severe headache, vomiting and visual field deterioration. The patient was treated conservatively because of her refusal of surgery and was followed-up for five years. In the course of treatment, recovery of the visual field defects, as well as right sixth cranial nerve paresis, was observed. Repeated magnetic resonance imaging (MRI) revealed regression of the tumour without signs of its re-growth. We discuss therapeutic modalities with particular emphasis on morbidity and review the literature relating to the management of pituitary tumour apoplexy.
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Keywords

pituitary apoplexy; hypopituitarism; deep venous thrombosis; pituitary tumour; transsphenoidal surgery

About this article
Title

Spontaneous regression of non-functioning pituitary adenoma due to pituitary apoplexy following anticoagulation treatment — a case report and review of the literature

Journal

Endokrynologia Polska

Issue

Vol 64, No 1 (2013)

Pages

54-58

Published online

2013-02-28

Bibliographic record

Endokrynologia Polska 2013;64(1):54-58.

Keywords

pituitary apoplexy
hypopituitarism
deep venous thrombosis
pituitary tumour
transsphenoidal surgery

Authors

Grzegorz Zieliński
Przemysław Witek
Andrzej Koziarski
Jan Podgórski

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