Pituitary apoplexy in a teenager--case report

Abstract

Background: Pituitary apoplexy is a rare clinical emergency which results from hemorrhage or infarction in the pituitary gland.

Patient: We present a 14-year-old girl with pituitary apoplexy and review the literature.

Results: Our patient experienced blurred vision, nausea, and headache. Her best-corrected visual acuity was 20/200 and 20/20. Confrontation test visual field testing revealed bitemporal hemianopsia. Brain imaging demonstrated a suprasellar mass. The microscopic endonasal transsphenoidal approach only found 5-10 mL brownish fluid-like material. Pathology confirmed no malignancy. Pituitary apoplexy was diagnosed. Her nausea and headache gradually improved. Six months after operation, her best-corrected visual acuity had improved to 20/30 and 20/20.

Conclusions: Although pituitary apoplexy is rare in pediatric patients, prompt evaluation including detailed ophthalmic examination, biochemical evaluation, endocrine workup, and image study are very important.

Keywords: bitemporal hemianopsia; hemorrhage in the pituitary gland; pituitary apoplexy; teenager.