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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2023; 84(03): e71-e79
DOI: 10.1055/s-0043-1770788
Case Report

Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review

Abigail Funari 
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Seth S. Jeong
2   Department of Otolaryngology—Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Isabella L. Pecorari
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Isabella Flaquer
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Cassidy L. Anderson 
2   Department of Otolaryngology—Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Vijay Agarwal
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
2   Department of Otolaryngology—Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
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Abstract

Introduction We present two cases of suspected pituitary apoplexy found instead to be infarcted pituitary glands without histopathologic evidence of neoplastic cells, likely resulting from spontaneous infarction of previously healthy pituitary glands.

Case Presentations The first case is a 55-year-old man who presented with a pulsating headache, nausea, and several months of decreased libido, polyuria, and polydipsia. Magnetic resonance imaging (MRI) revealed a rim-enhancing sellar/suprasellar mass with evidence of recent hemorrhage on the right. Testosterone, follicle-stimulating hormone, and luteinizing hormone levels were suppressed. Analysis of the resected specimen showed fibrocollagenous tissue with evidence of old hemorrhage and microscopic focus of necrotic tissue. The second case is a 56-year-old man who presented with a throbbing headache, associated nausea, and 6 weeks of polyuria and polydipsia. Testosterone levels were found to be low, and 8-hour water deprivation test showed evidence for partial diabetes insipidus. MRI revealed a mass on the right side of the pituitary gland, with evidence of likely hemorrhage on the left. Analysis of the resected specimen showed necrotic tissue without neoplastic cells.

Conclusion When evaluating small pituitary lesions in patients presenting with indolent onset of pituitary insufficiency, there should be a high degree of suspicion for an infarcted pituitary gland.

Keywords

pituitary apoplexy - pituitary infarction - infarctive apoplexy - pituitary insufficiency - necrotic pituitary


Publikationsverlauf

Eingereicht: 22. September 2022

Angenommen: 26. Januar 2023

Artikel online veröffentlicht:
24. Juli 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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