Spontaneous Regression Of A Postpartum Pituitary Mass Demonstrated By Computed Tomography

Abstract

Forty-four untreated patients with an enlarged sella were studied (excluding patients with acromegaly, Cushing’s disease, and those with radiological evidence of suprasellar extension). In 20 patients CT revealed a completely or partially empty sella. Based on recent studies we take this finding to signify the previous presence of a pituitary adenoma which has undergone complete or partial necrosis. Ten of the 20 patients had in fact experienced symptoms typical of a pituitary apoplexy compared with only one out of the other 24 patients. Adrenal, thyroid, and growthhormone insufficiency occurred as often in patients with an empty sella as in those with a solid pituitary tumour. In contrast, plasma prolactin levels were much lower in patients with an empty sella than in patients with a solid tumour (11 vs 166 nanograms/ml). It is assumed that this discrepancy reflects previous necrosis occurring in an adenoma hypersecreting prolactin. These results emphasize the importance of taking the spontaneous course of pituitary adenomas into account when assessing the effect of various treatment protocols.