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Physiologic pituitary hyperplasia causing visual disturbance during adolescence.

Yasuyuki Kinoshita1, Fumiyuki Yamasaki1, Atsushi Tominaga2

  • 1Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|November 25, 2018
PubMed
Summary

Physiologic pituitary hyperplasia in adolescents can cause temporary visual disturbances like bitemporal hemianopsia. This condition, often linked to exercise, may resolve on its own or require surgical decompression.

Keywords:
AdolescencePathological hyperplasiaPhysiologic hyperplasiaPituitaryPubescenceVisual disturbance

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Area of Science:

  • Endocrinology
  • Neuro-ophthalmology
  • Pediatric Endocrinology

Background:

  • Physiologic pituitary hyperplasia is a rare condition.
  • Adolescence is a period of significant hormonal changes impacting the pituitary gland.
  • Visual disturbances can arise from optic chiasm compression.

Observation:

  • Two adolescent cases presented with pituitary mass lesions on MRI, headaches, and exercise-induced visual disturbances.
  • Case 1: A 15-year-old boy experienced transient bitemporal hemianopsia, with MRI showing pituitary hyperplasia compressing the optic chiasm. Symptoms resolved spontaneously.
  • Case 2: A 14-year-old girl presented with acute visual disturbance and headache during exercise, diagnosed as pituitary apoplexy secondary to hyperplasia. Emergency surgery led to immediate recovery.

Findings:

  • Physiologic pituitary hyperplasia can manifest as a pituitary mass lesion.
  • Compression of the optic chiasm by the hyperplastic pituitary gland can cause visual field defects.
  • Symptoms may be transient and resolve spontaneously or necessitate surgical intervention.

Implications:

  • This study highlights physiologic pituitary hyperplasia as a potential cause of visual disturbance in adolescents.
  • Careful consideration is needed when diagnosing pituitary mass lesions in this age group.
  • Surgical intervention should be weighed against the possibility of spontaneous resolution or non-pathologic hyperplasia.