Faculty Collaboration Database

Silent pituitary apoplexy: subclinical infarction of an adrenocorticotropin-producing pituitary adenoma. J Clin Endocrinol Metab 1981 Jan;52(1):95-7

Date

01/01/1981

Pubmed ID

6256408

DOI

10.1210/jcem-52-1-95

Scopus ID

2-s2.0-0019378290 (requires institutional sign-in at Scopus site)   75 Citations

Abstract

A young woman developed intermittent headaches and progressive hyperpigmentation after bilateral adrenalectomy for Cushing's disease. Results of sellar polytomography were abnormal. Her plasma ACTH levels increased to 4750-7340 pg/ml and did not rise with insulin-induced hypoglycemia. Although she experienced no clinical features associated with spontaneous infarction of a pituitary tumor, plasma ACTH levels fell to 474-575 pg/ml, and hemorrhagic necrosis was found in a 5-mm chromophobe adenoma at transsphenoidal surgery. Postoperatively, ACTH levels returned to normal (51-88 pg/ml), with the rest of her anterior pituitary function remaining intact 4 yr later. Spontaneous infarction of pituitary microadenomas may be subclinical, resulting in improvement of pituitary hormone hypersecretion without impairment of other anterior pituitary hormone secretion.

Author List

Findling JW, Tyrrell JB, Aron DC, Fitzgerald PA, Wilson CB, Forsham PH

Author

James W. Findling MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoma, Chromophobe
Adrenalectomy
Adrenocorticotropic Hormone
Adult
Female
Humans
Infarction
Kinetics
Nelson Syndrome
Pituitary Neoplasms