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Pituitary Apoplexy Precipitated by Systemic Chemotherapy
Forrest A Hamrick1, Matthew C Findlay1, Robert C Rennert1
1Neurosurgery, University of Utah, Salt Lake City, USA.
Cureus
|May 5, 2022
Summary
Pituitary apoplexy is rare during chemotherapy. This case highlights a patient with testicular cancer experiencing pituitary apoplexy after chemotherapy, prompting a review of similar rare events.
Area of Science:
- Endocrinology
- Oncology
- Neurology
Background:
- Pituitary apoplexy, a rare endocrine emergency, typically affects undiagnosed pituitary adenomas without predisposing factors.
- Systemic chemotherapy is an uncommon precipitating event for pituitary apoplexy.
Observation:
- A 31-year-old man with newly diagnosed metastatic testicular cancer presented with acute symptoms including headache, nausea, and visual field deficit.
- These symptoms emerged one week after commencing bleomycin, etoposide, and cisplatin chemotherapy.
Findings:
- Imaging confirmed pituitary apoplexy, specifically hemorrhage within a pituitary macroadenoma.
- The patient underwent urgent transnasal resection for the condition.
Implications:
- This case adds to the scarce literature on pituitary apoplexy occurring during systemic chemotherapy.
- It underscores the importance of considering pituitary apoplexy in cancer patients presenting with relevant neurological symptoms during treatment.
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