Pituitary Function In Patients With Evidence Of Spontaneous Disappearance Of A Pituitary Adenoma
Clinical Endocrinology 18(6): Jun 1983; 599-603
View Original Source →Abstract
We have encountered a case of pituitary mass which emerged and enlarged during pregnancy in a 29-year-old woman. On CT scanning the mass disappeared over the course of four months postpartum and was followed by pituitary hypofunction. The hypofunction was restricted to ACTH, GH, and PRL. The visual field defects, bitemporal hemianopsia, disappeared with disappearance of the pituitary mass on CT scanning, indicating that such deficits during this period were reversible. Based on the clinical course and laboratory data, this case is thought to have been lymphocytic adenohypophysitis. It was concluded that among cases of pituitary masses developing during pregnancy there are some cases which do not require surgical therapy.
Case Details
Clinical Characteristics
In 20 patients CT revealed a completely or partially empty sella. 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 growth hormone 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).
Remission Characteristics
Spontaneous disappearance of a pituitary adenoma
Treatment & Mechanisms
Proposed Remission Mechanisms
It is assumed that this discrepancy reflects previous necrosis occurring in an adenoma hypersecreting prolactin.
Additional Notes
These results emphasize the importance of taking the spontaneous course of pituitary adenomas into account when assessing the effect of various treatment protocols.