Abstract:
:We report the case of a 60 year old male who complained of headache and blurry vision--that progressed to left ophthalmoplegia and ptosis--after receiving a dose of leuprolide for Prostate cancer therapy. Imaging showed a hemorrhagic sellar mass. The patient underwent transsphenoidal debulking, and the tissue obtained demonstrated immunohistochemical staining for LH. A literature review revealed nine previously reported cases of pituitary apoplexy after GnRH agonist therapy for prostate cancer. In most cases, the sellar tissues stained for LH, consistent with a gonadotropinoma. The pathophysiology of these events is unclear, but recent animal models suggest possible explanations. The predominance of gonadotropinomas is important because they do not usually present with hypersecretory symptoms. Particular attention to clinical findings suggestive of a non functioning pituitary tumor in patients receiving GnRH agonist therapy is critical as routine screening with MRI is not practical.
journal_name
Pituitaryjournal_title
Pituitaryauthors
Guerra Y,Lacuesta E,Marquez F,Raksin PB,Utset M,Fogelfeld Ldoi
10.1007/s11102-009-0202-2subject
Has Abstractpub_date
2010-01-01 00:00:00pages
54-9issue
1eissn
1386-341Xissn
1573-7403journal_volume
13pub_type
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