Pituitary apoplexy after surgery for cervical stump adenocarcinoma: A case report and literature review

Yu,Xiaodan; Shi,Chen; Jiang,Lili; Liu,Kuiran

doi:10.3892/ol.2024.14543

Pituitary apoplexy after surgery for cervical stump adenocarcinoma: A case report and literature review

Authors:
- Xiaodan Yu
- Chen Shi
- Lili Jiang
- Kuiran Liu
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Affiliations: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
Published online on: June 28, 2024 https://doi.org/10.3892/ol.2024.14543
Article Number: 411
Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pituitary apoplexy (PA) is an emergency condition caused by sudden hemorrhage or infarction and characterized by sudden sella turcica compression, intracranial hypertension and meningeal stimulation. PA usually occurs secondary to pituitary adenomas and can serve as the initial manifestation of an undiagnosed pituitary adenoma in an individual. In the present study, a case of PA following surgery for cervical stump adenocarcinoma was reported. The patient experienced an abrupt onset of headache and drowsiness on postoperative day 1 (POD1), and developed blurred vision and blepharoptosis of the left eye on POD4. Pituitary MRI confirmed the diagnosis of PA, prompting the initial administration of hydrocortisone to supplement endogenous hormones, followed by trans‑sphenoidal resection. At the six‑week follow‑up, the patient had fully recovered, with only mild residual blurring of vision. Diagnosing PA post‑surgery can be a challenging task due to its symptomatic overlap with postoperative complications. The existing literature on PA after surgery was also reviewed, including the symptoms, time of onset, imageological examination, management, potential risk factors and outcome to improve on early detection and individualized treatment in the future.

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