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Transsphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy.
- Source :
-
Neuro endocrinology letters [Neuro Endocrinol Lett] 2012; Vol. 33 (5), pp. 483-8. - Publication Year :
- 2012
-
Abstract
- Prolactinoma is the most common secreting pituitary adenoma. It is typically diagnosed in women of reproductive age and is common cause of infertility. Currently the treatment of choice is pharmacotherapy with dopamine agonists, whereas surgical treatment is reserved for a selected group of patients. Pituitary-tumor apoplexy is a rare, life-threatening condition associated with significant morbidity and mortality. The authors present the case of a 25-year-old woman with prolactinoma treated with dopamine agonist. In course of such a treatment the patient became pregnant. The bromocriptine was gradually withdrawn. In the 14th week of pregnancy she was admitted for symptoms suggesting pituitary tumor apoplexy. The treatment with bromocriptine was reinitiated. In the 20th week of pregnancy further deterioration of the patient's neurological condition and visual-field abnormalities were observed. The patient was qualified for surgical treatment - selective transsphenoidal adenomectomy. The successful surgery led to improvement of neurological condition. The early postoperative PRL level decreased significantly and hormonal function of the pituitary was preserved. The pregnancy ended in 38th week with a caesarean section. Endocrinological evaluation conducted after the uneventful delivery confirmed normal function of the pituitary. Magnetic resonance imaging (MRI) did not reveal tumor re-growth. The patient is kept under constant medical care. In this case study the authors discussed therapeutic management and reviewed literature regarding gestational pituitary-tumor apoplexy with particular emphasis on surgical treatment.
- Subjects :
- Adult
Critical Illness
Dopamine Agonists therapeutic use
Female
Humans
Pituitary Apoplexy drug therapy
Pituitary Apoplexy pathology
Pituitary Neoplasms drug therapy
Pituitary Neoplasms pathology
Pregnancy
Pregnancy Complications drug therapy
Pregnancy Complications pathology
Prolactinoma drug therapy
Prolactinoma pathology
Sphenoid Bone surgery
Neurosurgical Procedures methods
Pituitary Apoplexy surgery
Pituitary Neoplasms surgery
Pregnancy Complications surgery
Prolactinoma surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0172-780X
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Neuro endocrinology letters
- Publication Type :
- Academic Journal
- Accession number :
- 23090264