@IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.
neurology
Scopus Publications
Valentina Puglisi, Elisabetta Morini, Fiammetta Biasini, Luisa Vinciguerra, Giuseppe Lanza, and Placido Bramanti
MDPI AG
Background: Giant pituitary adenomas are benign intracranial tumours with a diameter ≥4 cm. Even if hormonally non-functional, they may still cause local extension, leading to symptoms that include mostly gland dysfunction, mass effects, and, much less frequently, apoplexy due to haemorrhage or infarction. Neurological presentation of giant pituitary tumour apoplexy is even more rare and has not been systematically reviewed. Case Presentation: An 81-year-old woman was admitted to the Emergency Department because of acute onset headache, bilateral visual deficit, and altered consciousness. Computed tomography showed a giant mass lesion (>5.5 cm diameter) expanding upward to the suprasellar cistern, optic chiasm, and third ventricle, over-running the sphenoid sinus, and with lateral invasion of the cavernous sinus. Laboratory investigations revealed central adrenal and hypothyroidism insufficiency, while magnetic resonance imaging confirmed a voluminous suprasellar tumour (~6 cm diameter), with signs of pituitary tumour apoplexy. Neurological manifestations and gland-related deficits improved after hormonal replacement therapy with a high dose of intravenous hydrocortisone, followed by oral hydrocortisone and levo-thyroxine. The patient declined surgical treatment and follow-up visit. Conclusions: Giant pituitary tumour apoplexy is a rare but potentially life-threatening condition. Prompt diagnosis and multidisciplinary management may allow a remarkable clinical improvement, as seen in this case.
Simona Portaro, Fiammetta Biasini, Placido Bramanti, Antonino Naro, and Rocco Salvatore CalabrĂ²
Ovid Technologies (Wolters Kluwer Health)
Giovanni Meola, Fiammetta Biasini, Rea Valaperta, Elena Costa, and Rosanna Cardani
Springer Science and Business Media LLC
F. Biasini, S. Portaro, A. Mazzeo, G. Vita, G.M. Fabrizi, F. Taioli, A. Toscano, and C. Rodolico
Elsevier BV
Carmelo Rodolico, Daniela Parisi, Simona Portaro, Fiammetta Biasini, Stefano Sinicropi, Annamaria Ciranni, Antonio Toscano, Sonia Messina, Olimpia Musumeci, Giuseppe Vita,et al.
IOS Press