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Updated: Feb 11, 2026

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Published on: November 29, 2018
Extensive Pituitary Apoplexy after Chemotherapy in a Patient with Metastatic Breast Cancer
Je Hun Jang1, Young San Ko1, Eun Kyeong Hong2
1Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
Abstract:
Surgery, anticoagulation therapy, pregnancy, and hormone treatments, such as bromocriptine, are well-characterized precipitating factors for pituitary apoplexy. However, whether cytotoxic chemotherapy for systemic cancer could cause pituitary apoplexy has not been investigated. Here, we present a case of a 41-year-old woman who developed a severe headache with decreased visual acuity after intravenous cytotoxic chemotherapy to treat metastatic breast cancer. Preoperative neuroimaging revealed pituitary adenoma with necrosis. Operative findings and pathologic examination concluded extensive necrosis with a small intratumoral hemorrhage in a pre-existing pituitary adenoma. We reviewed two additional previously published cases of pituitary apoplexy after systemic chemotherapy and suggest that cytotoxic chemotherapy may induce pituitary apoplexy.
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