Endocrine Abstracts

Introduction: Pituitary tumours are known to cause headaches and visual troubles by compressing pituitary adjacent structures. Pressure on more distant structures is exceptional. In very large tumours such as prolactinomas, mixed adenomas or craniopharyngiomas, hydrocephalus, convulsions, memory troubles and even unconsciousness can be observed, but to our best knowledge motor deficits, such as hemiplegia or hemi paresis, are rarely reported as clinical presentations in pituitary tumours. Our aim is to report four pituitary tumours with hemi paresis or hemiplegia in order to emphasis the different mechanisms of such neurological troubles.

Case reports: Two men aged 30 and 41, a woman of 26 years old, and a baby aged 5 months were sent for progressive or acute hemi paresis/hemiplegia related to pituitary tumours. In these cases pituitary tumours were all giant (height>4 cm), invasive (invasion of cavernous sinuses), and compressing distant cerebral structures. After medical treatment, the neurological deficits resolved in subjects with prolactinomas. Unfortunately, the 4th case with craniopharyngioma and active hydrocephalus worsened, and then died.

Conclusion: Although hemi paresis and hemiplegia are very rare clinical presentations in people with pituitary tumours; this aetiology should be kept in mind, as motor deficits can disappear after adequate treatment of pituitary tumours, especially large prolactinomas, as in the reported cases.