ECE2013 Poster Presentations Clinical case reports – Pituitary/Adrenal (57 abstracts)
Pituitary apoplexy after suppression test in a patient with Cushing’s disease due to macroadenoma
Fatih Kuzu 1, , Taner Bayraktaroglu 1, , Ayfer Altas Erdogan 2 , Sevil Uygun Ilikhan 2 , Muammer Bilici 2 , Sanser Gul 3 & Ozlem Tokgoz 4
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey; 2Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey; 3Department of Neurosurgery, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey; 4Department of Radiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
Introduction: Cushing’s disease is not likely to be pituitary apoplexy or macroadenoma. We present a case of pituitary apoplexy after dexamethasone suppression test for Cushing’s disease due to macroadenoma.
Case report: A 30-year-old man complained of headache and closure of the left upper eyelid. Two years ago he had a headache, and was diagnosed with non-functional macroadenoma of pituitary. In follow, insuppressibly serum levels of cortisol with dexamethasone were detected with normal levels of ACTH. He complained with headache and ptosis in the left upper eyelid with sudden loss of vision in the left. Magnetic resonance imaging of the sella turcica showed definitive pituitary apoplexy and macroadenoma. Hemorrhagic diathesis tests were normal. He was treated successfully by endoscopic endonasal transsphenoidal surgery within several hours after onset of pituitary apoplexy. His symptoms and signs were significantly improved.
He is followed by glucocorticoid replacement therapy with L-thyroxine and androgen.
Conclusions: Endocrine stimulation tests need to be careful in patients with pituitary macroadenoma, and should be assessed on a case-by-case basis. Pituitary apoplexy and macroadenoma in the present patient is not likely to be seen in Cushing’s disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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