Regression Of Pituitary Macroadenoma After Pituitary Apoplexy: Ct And Mr Studies
Armstrong, M. R., Douek, M., Schellinger, D., & Patronas, N. J. (1991). Regression of pituitary macroadenoma after pituitary apoplexy: CT and MR studies. Journal of computer assisted tomography, 15(5), 832–834. https://doi.org/10.1097/00004728-199109000-00021
View Original Source →Abstract
We present a case of a patient with apoplexy due to infarction of a large pituitary macroadenoma. Conservative treatment with steroids resulted in reversal of symptoms and the adenoma involuted. This suggests that medical management may be sufficient therapy in some patients with this complication.
Case Details
Disease Location
Pituitary macroadenoma
Personal Characteristics
66-year-old male with cad, heart failure
Clinical Characteristics
Presented with eye pain, loss of libido, gynecomastia, visual field defect on testing. CT head showed a 1.9x2x2.5 cm homogeneously enhancing pituitary tumor with large suprasellar component. Hormonal levels of lh, fsh, testosterone were low, high prolactin. Placed on hormones replacement over next 7 months but also developed progressive visual field loss, MRI showed enlarging tumor. Pre-op (for elective spenoidectomy) cardiac evaluation prompatiented cabg -> 36 hrs later he developed pituitary apoplexy. Started on IV dexamethasone. Symptoms improved over next 3 days. CT after 15 days showed regressing tumor. Continued on hormonal replacement but visual symptoms improved MRI 11 month later confirmed involution of tumor.
Remission Characteristics
36 hrs after cabg, he developed pituitary apoplexy. Started on IV dexamethasone. Symptoms improved over next 3 days. CT after 15 days showed regressing tumor. Continued on hormonal replacement but visual symptoms improved MRI 11 month later confirmed involution of tumor.
Treatment & Mechanisms
Proposed Remission Mechanisms
Tumor infarction
Clinical Treatment
Hormones replacement. IV steroids for apoplexy