L Giammattei1,2, G Mantovani3,4, G Carrabba1, S Ferrero5,6, A Di Cristofori1,2, E Verrua3,4, C Guastella7,4, L Pignataro7,4, P Rampini1, M Minichiello8,9, M Locatelli1. 1. Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 2. Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy. 3. Unit of Endocrinology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 5. Unit of Pathology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. 7. Unit of Otolaringology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 8. Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. marina.minichiello@unimi.it. 9. Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy. marina.minichiello@unimi.it.
Abstract
PURPOSE: To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors. METHODS: Clinical presentation of our series of cases. Contemporary published literature is also reviewed. RESULTS: The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma. CONCLUSION: Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.
PURPOSE: To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors. METHODS: Clinical presentation of our series of cases. Contemporary published literature is also reviewed. RESULTS: The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma. CONCLUSION:Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.
Authors: D C Bills; F B Meyer; E R Laws; D H Davis; M J Ebersold; B W Scheithauer; D M Ilstrup; C F Abboud Journal: Neurosurgery Date: 1993-10 Impact factor: 4.654
Authors: Kinga Németh; Nikolette Szücs; Sándor Czirják; Lilla Reiniger; Borbála Szabó; Gábor Barna; Katalin Karászi; Péter Igaz; Vladimir Zivkovic; Márta Korbonits; Attila Patócs; Henriett Butz Journal: Oncotarget Date: 2018-06-26