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

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...

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Autores principales: Funari, Abigail, Jeong, Seth S., Pecorari, Isabella L., Flaquer, Isabella, Anderson, Cassidy L., Agarwal, Vijay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365896/
https://www.ncbi.nlm.nih.gov/pubmed/37492614
http://dx.doi.org/10.1055/s-0043-1770788
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author Funari, Abigail
Jeong, Seth S.
Pecorari, Isabella L.
Flaquer, Isabella
Anderson, Cassidy L.
Agarwal, Vijay
author_facet Funari, Abigail
Jeong, Seth S.
Pecorari, Isabella L.
Flaquer, Isabella
Anderson, Cassidy L.
Agarwal, Vijay
author_sort Funari, Abigail
collection PubMed
description 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.
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spelling pubmed-103658962023-07-25 Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review Funari, Abigail Jeong, Seth S. Pecorari, Isabella L. Flaquer, Isabella Anderson, Cassidy L. Agarwal, Vijay J Neurol Surg Rep 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. Georg Thieme Verlag KG 2023-07-24 /pmc/articles/PMC10365896/ /pubmed/37492614 http://dx.doi.org/10.1055/s-0043-1770788 Text en 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/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Funari, Abigail
Jeong, Seth S.
Pecorari, Isabella L.
Flaquer, Isabella
Anderson, Cassidy L.
Agarwal, Vijay
Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title_full Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title_fullStr Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title_full_unstemmed Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title_short Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
title_sort infarctive apoplexy of previously healthy pituitary glands: a small case series and literature review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365896/
https://www.ncbi.nlm.nih.gov/pubmed/37492614
http://dx.doi.org/10.1055/s-0043-1770788
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