Pituitary apoplexy in an adrenocorticotropin-producing pituitary macroadenoma. 2010

Serap Baydur Sahin, and S Cetinkalp, and M Erdogan, and U Cavdar, and G Duygulu, and F Saygili, and C Yilmaz, and A G Ozgen
Department of Endocrinology and Metabolism Disease, Ege University Medical School, 35100, Izmir, Turkey. serapbaydur@gmail.com

Adrenocorticotropin (ACTH) producing macroadenomas and pituitary apoplexy are unusual in Cushing' s disease. A 20-year-old man who had been diagnosed Cushing' s disease 2 months ago, presented with sudden headache, nausea, and vomiting. His serum cortisol level was 0.4 μg/dl and ACTH level was 23.9 pg/ml. Magnetic resonance imaging of the pituitary gland disclosed a hemorrhage in the pituitary macroadenoma (22×19 mm). He was treated with IV methylprednisolone immediately and then the symptoms were relieved within the first day of the treatment. The hemorrhagic lesion was resected by transsphenoidal surgery successfully. Impaired secretion of pituitary hormones may be seen after the pituitary apoplexy. We communicate a case with pituitary apoplexy of an ACTH secreting pituitary macroadenoma, causing acute glucocorticoid insufficiency.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D010899 Pituitary Apoplexy The sudden loss of blood supply to the PITUITARY GLAND, leading to tissue NECROSIS and loss of function (PANHYPOPITUITARISM). The most common cause is hemorrhage or INFARCTION of a PITUITARY ADENOMA. It can also result from acute hemorrhage into SELLA TURCICA due to HEAD TRAUMA; INTRACRANIAL HYPERTENSION; or other acute effects of central nervous system hemorrhage. Clinical signs include severe HEADACHE; HYPOTENSION; bilateral visual disturbances; UNCONSCIOUSNESS; and COMA. Apoplexy, Pituitary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000236 Adenoma A benign epithelial tumor with a glandular organization. Adenoma, Basal Cell,Adenoma, Follicular,Adenoma, Microcystic,Adenoma, Monomorphic,Adenoma, Papillary,Adenoma, Trabecular,Adenomas,Adenomas, Basal Cell,Adenomas, Follicular,Adenomas, Microcystic,Adenomas, Monomorphic,Adenomas, Papillary,Adenomas, Trabecular,Basal Cell Adenoma,Basal Cell Adenomas,Follicular Adenoma,Follicular Adenomas,Microcystic Adenoma,Microcystic Adenomas,Monomorphic Adenoma,Monomorphic Adenomas,Papillary Adenoma,Papillary Adenomas,Trabecular Adenoma,Trabecular Adenomas
D047748 Pituitary ACTH Hypersecretion A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME. Cushing Disease,Cushing's Disease,Inappropriate ACTH Secretion Syndrome,Inappropriate Adrenocorticotropic Hormone Secretion,Adrenocorticotropic Hormone, Inappropriate Secretion,Cushing Disease, Pituitary,Pituitary Cushing Syndrome,Pituitary-Dependant Cushing Syndrome,Pituitary-Dependant Hypercortisolism,Pituitary-Dependant Hypercortisolism Disorder,Cushing Syndrome, Pituitary,Cushing Syndrome, Pituitary-Dependant,Disease, Cushing,Hypercortisolism Disorder, Pituitary-Dependant,Hypercortisolism, Pituitary-Dependant,Hypersecretion, Pituitary ACTH,Pituitary Cushing Disease,Pituitary Dependant Cushing Syndrome,Pituitary Dependant Hypercortisolism,Pituitary Dependant Hypercortisolism Disorder,Pituitary-Dependant Hypercortisolism Disorders,Pituitary-Dependant Hypercortisolisms
D049913 ACTH-Secreting Pituitary Adenoma A pituitary adenoma which secretes ADRENOCORTICOTROPIN, leading to CUSHING DISEASE. Corticotroph Adenoma,Pituitary Adenoma, ACTH-Secreting,Pituitary Corticotropin-Secreting Adenoma,ACTH-Producing Pituitary Adenoma,ACTH Producing Pituitary Adenoma,ACTH Secreting Pituitary Adenoma,ACTH-Producing Pituitary Adenomas,ACTH-Secreting Pituitary Adenomas,Adenoma, Corticotroph,Adenomas, Corticotroph,Corticotroph Adenomas,Corticotropin-Secreting Adenoma, Pituitary,Corticotropin-Secreting Adenomas, Pituitary,Pituitary Adenoma, ACTH Secreting,Pituitary Adenoma, ACTH-Producing,Pituitary Adenomas, ACTH-Producing,Pituitary Adenomas, ACTH-Secreting,Pituitary Corticotropin Secreting Adenoma,Pituitary Corticotropin-Secreting Adenomas
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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