Two rare cases of pituitary apoplexy in adult females: a tricky diagnosis
Keywords:
Pituitary apoplexy, pituitary macroadenoma, neuroradiology, computed tomography, magnetic resonance imagingAbstract
We reported two cases of women who suffered from a rare case of pituitary apoplexy, rare and potentially fatal clinical condition due to a hemorrhagic infarction of the pituitary gland due to a pre-existing macroadenoma.
The onset of symptoms is often insidious and includes generic symptoms such as headache, vomiting, and visual disturbances.
In this case report we discuss the typical CT and MRI imaging features of this rare clinical condition in order to help radiologists in the timely diagnosis for a more rapid and correct diagnostic framing.
References
Bailey P (1898) Pathological report of a case of acromegaly with special reference to the lesions in hypophysis cerebri and in the thyroid gland, and a case of hemorrhage into the pituitary. Phila Med J 1:789–792
Brougham M, Heusner AP, Adams RD (1950) Acute degenerative changes in adenomas of the pituitary body—with special reference to pituitary apoplexy. J Neurosurg 7:421–439
Wakai S, Fukushima T, Teramoto A, Sano K (1981) Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 55:187–193
Cardoso ER, Peterson EW (1984) Pituitary apoplexy: a review. Neurosurgery 14:363–373
Dubuisson AS, Beckers A, Stevenaert A (2007) Classical pituitary tumour apoplexy: clinical features, management and outcomes in a series of 24 patients. Clin Neurol Neurosurg 109:63–70
Ebersold MJ, Laws ER, Scheithauer BW, Randall RV (1983) Pituitary apoplexy treated by transsphenoidal surgery. A clinicopathological and immunocytochemical study. J Neurosurg 58:315–320
Mohr G, Hardy J (1983) Haemorrhage, necrosis and apoplexy in pituitary adenomas. Surg Neurol 18:181–189
Rovit RL, Fein JM (1972) Pituitary apoplexy: a review and reappraisal. J Neurosurg 37:280–288
Bills DC, Meyer FB, Laws ER et al (1993) A retrospective analysis of pituitary apoplexy. Neurosurgery 33(4):602–609
Fraioli B, Esposito V, Palma L, Cantore G (1990) Hemorrhagic pituitary adenomas: clinicopathological features and surgical treat- ment. Neurosurgery 27(5):741–748
Onesti ST, Wisniewski T, Post KD (1990) Clinical versus subclinical pituitary apoplexy: presentation, surgical management and outcome in 21 patients. Neurosurgery 26(6):980–986
Boellis A, di Napoli A, Romano A, Bozzao A. Pituitary apoplexy: an update on clinical and imaging features. Insights Imaging. 2014 Dec;5(6):753-62.
Pant B, Arita K, Kurisu K, Tominaga A, Eguchi K, Uozumi T (1997) Incidence of intracranial aneurysm associated with pituitary adeno- ma. Neurosurg Rev 20:13–17
Randeva H, Schoebel J, Byrne J, Esiri M, Adams C, Wass J (1999) Classical pituitary apoplexy: clinical features, management and out- come. Clin Endocrinol 51:181–188
Couture N, Aris-Jilwan N, Serri O (2012) Apoplexy of microprolactinoma during pregnancy: case report and review of literature. Endocr Pract 18(6):e147–e150
Goyal P, Utz M, Gupta N, et al. Clinical and imaging features of pituitary apoplexy and role of imaging in differentiation of clinical mimics. Quant Imaging Med Surg. 2018;8(2):219-231. doi:10.21037/qims.2018.03.08
Semple PL, Jane JA, Lopes MBS, Laws ER (2008) Pituitary apoplexy: correlation between magnetic resonance imaging and histopathological results. J Neurosurg 108:909–915
Rogg JM, Tung GA, Anderson G, et al. Pituitary apoplexy: early detection with diffusion-weighted MR imaging. AJNR Am J Neuroradiol 2002;23:1240-5.
Wildemberg LE, Glezer A, Marcello DB, et al. Apoplexy in nonfunctioning pituitary adenomas. Pituitary 2018;21:138-44.
Albani A, Ferraù F, Angileri F, et al. Multidisciplinary Management of Pituitary Apoplexy. Int J Endocrinol. 2016;7951536.
Bonneville F, Cattin F, Marsot-Dupuch K, Dormont D, Bonneville JF, Chiras J (2006) T1 signal hyperintensity in the sellar region: spectrum of findings. Radiographics 26:93–113
Osborn AG (1972) Pituitary apoplexy. In: Osborn A, Salzman KL, Barkovich AJ (eds) Diagnostic imaging. Brain, 2nd edn. Amirsys Inc, Salt Lake City, II-2-28-31
Glezer A, Bronstein MD. Pituitary apoplexy: pathophysiology, diagnosis and management. Arch Endocrinol Metab. 2015;59(3):259-264. doi:10.1590/2359-3997000000047
Giritharan S, Gnanalingam K, Kearney T. Pituitary apoplexy – Bespoke patient management allows good clinical outcome. Clin Endocrinol 2016;85:415-22.
Rajasekaran S, Vanderpump M, Baldeweg S, et al. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol 2011;74:9-20
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Copyright (c) 2023 Umberto Tupputi, Valentina Testini, Maria Grazia Rita Manco, Maria Teresa Paparella, Roberto Bellitti, Giuseppe Guglielmi
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