Apoplexy of A Microprolactinoma During Pregnancy: Case Report and Review of Literature |
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| Institution: | 1. Division of Endocrinology, Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada.;1. Department of Psychiatry, University Hospital Rostock, Germany;2. University of Medicine and Pharmacy of Craiova, Chair of Biochemistry, Neurobiology of Aging Group, Romania;3. Department of Healthcare Science, Manchester Metropolitan University, Manchester, UK;4. Griffith University School of Medicine, Gold Coast Campus, QLD 4222, Australia;1. Orthopaedic Research Laboratories, University of Michigan, Room 2003 Biomedical Sciences Research Building, 109 Zina Pitcher Place, Ann Arbor, MI 48109, USA;2. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Ave., Ann Arbor, MI 48109, USA;3. Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Room 145 Myrin Bldg, Kennett Square PA;4. Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA |
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| Abstract: | ObjectiveTo report a rare case of apoplexy in a microprolactinoma during pregnancy.MethodsWe present the initial clinical manifesta tions, laboratory results, radiologic findings, and man agement in a patient who had pituitary apoplexy during early pregnancy. The pertinent literature and management options are also reviewed.ResultsA 37-year-old woman with a history of a microprolactinoma presented during the 16th week of her first pregnancy with a sudden onset of severe headache, nausea, vomiting, and blurred vision. Magnetic resonance imaging showed a sellar heterogeneous mass with supra sellar extension and contact with the optic chiasm, com patible with adenoma apoplexy. The patient’s visual fields were normal. Conservative management was followed by rapid clinical improvement and a notable regression of the sellar mass after 5 weeks of cabergoline therapy. Uneventful pregnancy resulted in the delivery of a healthy baby. Repeated magnetic resonance imaging was per formed 1 week after delivery and showed resolution of the microadenoma. At 3 months after delivery, the patient had recovered regular menses and had sustained normal prolac tin levels without treatment.ConclusionThis case illustrates a rare occurrence of apoplexy in a microprolactinoma during pregnancy, which was managed conservatively and led to a complete regression of the pituitary tumor. 3Endocr Pract. 2012;18:e147-e150) |
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