Pituitary tumor apoplexy: a literature review

Authors

DOI:

https://doi.org/10.52076/eacad-v3i2.203

Keywords:

Pituitary gland; Pituitary apoplexy; Pituitary neoplasms; Review literature.

Abstract

Introduction: Pituitary apoplexy is a potentially fatal disorder due to acute ischemic infarction or hemorrhage of the pituitary gland. The main clinical features of this syndrome are headache, nausea, vomiting, visual impairment, altered mental status and even coma. Methodology: This is a systematic literature review of the quantitative type using the following Keywords: Adeno-Pituitary; Pituitary Apoplexy; Pituitary Neoplasms; Review of Reported Cases. Result: As the primary event involves the adenoma, the syndrome should be termed pituitary tumor apoplexy and not pituitary apoplexy. Although pituitary apoplexy occurs within pituitary adenomas, it can also occur in non-adenomatous or even normal pituitary, especially during pregnancy. Discussion: Although the terminology "subclinical pituitary apoplexy" is widely used to describe anatomopathological evidence of asymptomatic pituitary ischemia or hemorrhage, it is significant to note that pituitary apoplexy is a clinical syndrome and not an anatomopathological definition. Conclusion: although pituitary apoplexy is an uncommon complication of pituitary tumors, it must be recognized as a neuroendocrinological and neurosurgical emergency that requires immediate diagnosis and treatment, individualizing each individual to direct to conservative or more invasive therapies.

References

Sibal L, Ball S. G, Connolly V, et al. Pituitary apoplexy: a review of clinical presentation, management and outcome in 45 cases. Pituitary 2004; 7:157-163.

Elsässer Imboden P. N, De Tribolet N, Lobrinus A, et al. Apoplexy in pituitary macroadenoma: eight patients presenting in 12 months. Medicine 2005; 84:188-196.

Dubuisson A. S, Beckers A, Stevenaert A. Classical pituitary tumour apoplexy: clinical features, management and outcomes in a series of 24 patients. Clin Neurol Neurosurg 2007; 109:63-70.

Nawar R. N, AbdelMannan D, Selma W. R, Arafah B. M. Pituitary tumor apoplexy: a review. J Intensive Care Med 2008; 23:75-89.

Biousse V, Newman N. J, Oyesiku N. M. Precipitating factors in pituitary apoplexy. J Neurol Neurosurg Psychiatry 2001; 71:542-545.

Cunha-Neto M. B. C, Musolino N. R. C, Toscanini A. C. Síndrome da sela vazia e apoplexia hipofisária. In Saad MJA, Maciel RMB, Mendonça BB (Eds). Endocrinologia. São Paulo: Editora Atheneu, 2007:47-62.

Reid R. L, Quigley M. E, Yen S. S. Pituitary apoplexy. A review. Arch Neurol 1985; 42:712-719.

Wakai S, Fukushima T, Teramoto A, Sano K. Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 1981; 55:187-193.

Hirano A, Tomiyasu U, Zimmerman HM. The fine structure of blood vessels in chromophobe adenoma. Acta Neuropathol (Berl) 1972; 22:200-207.

Baker H. L Jr. The angiographic delineation of sellar and parasellar masses. Radiology 1972;104:67-78.

Semple P. L, De Villiers J. C, Bowen R. M, Lopes M. B, Laws E. R. Pituitary apoplexy: do histological features influence the clinical presentation and outcome? J Neurosurg 2006; 104:931-937.

Wongpraparut N, Pleanboonlers N, Suwattee P, et al. Pituitary apoplexy in a patient with acute myeloid leukaemia and thrombocytopenia. Pituitary 2000; 3:113-116.

Han, C., Lin, S., Lu, X., Xue, L., & Wu, Z. B. (2021). Tumor-Associated Macrophages: New Horizons for Pituitary Adenoma Researches. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.785050

García-Guzmán, B., Portocarrero-Ortiz, L., Dorantes-Argandar, A. A., & Mercado, M. (2020). Hereditary Pituitary Tumor Syndromes: Genetic and Clinical Aspects. Revista de Investigacion Clinica; Organo Del Hospital de Enfermedades de La Nutricion, 72(1), 8–18. https://doi.org/10.24875/RIC.19003186

Liu, X., Wang, R., Li, M., & Chen, G. (2021). Pituitary adenoma or pituitary neuroendocrine tumor: a narrative review of controversy and perspective. Translational Cancer Research, 10(4), 1916–1920. https://doi.org/10.21037/tcr-20-3446

Trouillas, J., Jaffrain-Rea, M.-L., Vasiljevic, A., Raverot, G., Roncaroli, F., & Villa, C. (2020). How to Classify Pituitary Neuroendocrine Tumors (PitNET)s in 2020. Cancers, 12(2), 514. https://doi.org/10.3390/cancers12020514

Banskota, S., & Adamson, D. C. (2021). Pituitary Adenomas: From Diagnosisto Therapeutics. Biomedicines, 9(5), 494. https://doi.org/10.3390/biomedicines9050494

Luo, P., Zhang, L., Yang, L., An, Z., & Tan, H. (2020). Progress in the Pathogenesis, Diagnosis, and Treatment of TSH-Secreting Pituitary Neuroendocrine Tumor. Frontiers in Endocrinology, 11. https://doi.org/10.3389/fendo.2020.580264

Published

16/06/2022

How to Cite

Paz, J. V. C., Alves, A. A. G. ., Alves, B. da C. ., Beckman, L. F. ., Almeida , D. C. C. ., Siqueira, R. D. M. ., Melo, A. de M., Nascimento, N. D. M. ., Moraes, D. M., Assis , A. L. L. M. de ., Sousa, A. C. M. de ., Pontes, D. de B. ., Freitas, C. M. de ., Santos, C. A. dos ., & Paixão, R. K. M. . (2022). Pituitary tumor apoplexy: a literature review. E-Acadêmica, 3(2), e4832203. https://doi.org/10.52076/eacad-v3i2.203

Issue

Section

Health and Biological Sciences