Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Pop,Lucian Gheorghe; Ilian,Aurora; Georgescu,Tiberiu; Bacalbasa,Nicolae; Balescu,Irina; Toader,Oana Daniela

doi:10.3892/etm.2022.11143

Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Authors:
- Lucian Gheorghe Pop
- Aurora Ilian
- Tiberiu Georgescu
- Nicolae Bacalbasa
- Irina Balescu
- Oana Daniela Toader
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Affiliations: Department of Obstetrics and Gynecology, National Institute of Mother and Child Care, 400012 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Victor Babes’ University of Medicine and Pharmacy, 300014 Timisoara, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, ‘Ponderas’ Academic Hospital, 021188 Bucharest, Romania
Published online on: January 14, 2022 https://doi.org/10.3892/etm.2022.11143
Article Number: 218

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Abstract

Gestational pituitary apoplexy is an extremely rare condition. It is characterised by an unexpected headache, vomiting, nausea, and visual disturbances. Pituitary apoplexy in pregnancy and postpartum is a challenging diagnosis with symptoms overlapping multiple conditions. There is a limited number of articles presenting cases or case series of gestational pituitary apoplexy. This is a potentially life‑threatening emergency which requires a high index of suspicion for its diagnosis. This article presents a case of postpartum pituitary apoplexy and outlines the current stage of clinical, imagistic diagnosis and management options. A 26‑year‑old primipara was submitted to a Caesarean section, with no perioperative incidents. Forty‑eight hours later she reported the apparition of frontal and temporal throbbing headaches, nausea, photophobia, and she was diagnosed with a pituitary tumor measuring 33x10.5x15.5 mm. Although initially conservative treatment was proposed, the clinical outcome was not favourable, thus the patient was submitted to endoscopic transsphenoidal resection. The histopathological studies demonstrated the presence of a pituitary macroadenoma. At the 2‑year follow‑up, the patient is free of disease. Although it represents an extremely rare condition, gestational pituitary apoplexy should be suspected whenever headache and neurological disorders such as nausea and photophobia are reported during the postpartum period.

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