Open AccessSpontaneous Resolution of a Nonfunctioning Pituitary Adenoma over One-Month Period: a Case Report
Author(s) -
Luka Komić,
Ivan Kruljac,
Gorana Mirošević,
Petar Gaćina,
Hrvoje Ivan Pećina,
Vatroslav Čerina,
Domagoj Gajski,
Kristina Blaslov,
Krešimir Rotim,
M. Vrkljan
Publication year - 2021
Publication title -
acta clinica croatica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.274
H-Index - 20
eISSN - 1333-9451
pISSN - 0353-9466
DOI - 10.20471/acc.2021.60.02.21
Subject(s) - medicine , pituitary apoplexy , pituitary adenoma , magnetic resonance imaging , adenoma , vomiting , pituitary gland , dexamethasone , etiology , photophobia , surgery , radiology , hormone
Spontaneous resolution of nonfunctioning pituitary adenoma after hemorrhagic apoplexy is a rare clinical entity of unknown etiology and is defined as disappearance of a tumor without any specific treatment. Here we present a 54-year-old male patient who presented with acute onset of severe headache, vomiting, photophobia, and sonophobia. He was referred to brain computed tomography, which showed a 16x12x16 mm tumor mass located in the sellar region with signs of hemorrhage. Endocrinologic evaluation was consistent with under-function of pituitary gonadotropic cells. Magnetic resonance imaging (MRI) performed ten days later was consistent with hemorrhagic apoplexy of the pituitary adenoma. The patient's symptoms resolved after conservative treatment with dexamethasone, but he was scheduled for elective pituitary surgery. Preoperative MRI was performed one month after the first one and disclosed normal pituitary gland without any signs of adenoma. Our case is remarkable due to the fact that spontaneous remission of pituitary adenoma occurred within the first month, which is the shortest interval reported to date. Our case highlights the importance of conservative therapy as the first-line treatment for pituitary apoplexy in the absence of neurological impairment, since spontaneous remission may occur in a short time interval.