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Spontaneous Regression Of Nonfunctioning Pituitary Adenoma

Ghalaenovi, H. 2019Brain tumor

Ghalaenovi, H., Azar, M., & Fattahi, A. (2019). Spontaneous regression of nonfunctioning pituitary adenoma. British Journal of Neurosurgery, 37(4), 769–770. https://doi.org/10.1080/02688697.2019.1630552

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Abstract

Eighty percent of pituitary macroadenomas are nonfunctioning and may be treated conservatively. Spontaneous regression occurs but is rare and generally has an identifiable cause such as chemotherapy, pituitary apoplexy and viral infections. We present a 28 year-old male with a nonfunctioning pituitary macroadenoma that regressed over one year without any apparent cause.

Case Details

Disease Location

Pituitary gland

Personal Characteristics

28 years-old male with congenital intellectual disability

Clinical Characteristics

Presented with long-term vault headache and 2 months of nausea and photophobia. Examination demonstrated mild bitemporal hemianopia, more prominent in the superior quadrants, with normal bilateral visual acuity. Brain MRI with and without gadolinium showed a 30x22x24mm enhancing sellar and suprasellar lesion extended to the 3rd ventricular floor and compressed the optic chiasma. Subclinical hypothyroidism and moderate prolactinemia as stalk effects.

Remission Characteristics

He was seen again after one year when all symptoms had recovered. A new brain MRI showed the tumor to have regressed to 17x13x15mm without any medical or surgical intervention

Treatment & Mechanisms

Proposed Remission Mechanisms

Spontaneous regression can occur in the natural history of nfpas.