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2017, Number 3

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Rev Cubana Cardiol Cir Cardiovasc 2017; 23 (3)

Pituitary tumor apoplexy after cardiac surgery

Fuentes GF, Pérez GA, Pascual BA, Sancho VI, Gurpegui PM, Mallor BT, García MP, Olmos PF

Language: Spanish
References: 22
Page:
PDF size: 440.39 Kb.


ABSTRACT

We report a case of a 78 years old male patient, admited in the Intensive Care Unity after elective mitro-aortic valve replacement. In the immediate postoperative period, the patient presented left eyelid ptosis, homolateral III cranial nerve palsy, hyponatremia and hypotension. Norepinephrine was required from the admission in the Unit. Cerebral CT and MRI were performed, showing a pituitary macroadenoma with sings of ischemic infarction in its tissue, and compression of the adyacent structures. Steroid and thyroid hormone replacement was administrated. The clinical progression was favorable and he was discharged. This is case of a pituitary tumor apoplexy, in a patient with a silent macroadenoma, precipitated by cardiac surgery.


REFERENCES

  1. Nawar RN, AbdelMannan D, SelmanWR, Arafah BM. Pituitary Tumor Apoplexy: A Review. J Intensive Care Med 2008;23: 75-90.

  2. Serramito-García R, García-Allut A, Arcos-Algaba AN; Castro-Bouzas D, Santín-Amo JM Gelabert-González M. Apoplejía pituitaria. Revisión del tema. Neurocirugía 2011; 22: 44-49.

  3. Elsässer PN, De Tribolet N, Lobrinus A, Gaillard RC, Portmann L, Pralong F, Gomez F. Apoplexy in Pituitary Macroadenoma. Eight Patients Presenting in 12 Months. Medicine 2005;84:188–196

  4. Mattke AF, Vender JR, Anstadt MP. Pituitary Apoplexy Presenting as Addisonian Crisis after Coronary Artery Bypass Grafting. Tex Heart Inst J 2002;29:193-9.

  5. Davies JS, Scanlon MF. Hypopituitarism after coronary artery bypass grafting. BMJ 1998;316:682–5.

  6. Pliam MB, Cohen M, Cheng L, Spaenle M, Bronstein MH, Atkin TW.Pituitary Adenomas Complicating Cardiac Surgery: Summary and Review of 11 Cases. J Card Surg 1995;10:125-132.

  7. Abbott J, Kirkby GR. Acute visual loss and pituitary apoplexy after surgery. BMJ 2004;329:218–9.

  8. Alzetani A, Fisher C, Costa R, Ohri SK. Ptosis Postcardiac Surgery: A Case of Pituitary Apoplexy. Ann Thorac Surg 2002;73:300–1.

  9. Zayour DH, Azar ST. Silent pituitary infarction after coronary artery bypass grafting procedure: case report and review of literature. Endocr Pract 2006;12:59-62.

  10. Zhang RC, Mu YF, Dong J, Lin XQ, Geng DQ. Complex effects of apoplexy secondary to pituitary adenoma. Rev Neurosci. 2017 Jan 1;28(1):59-64.

  11. Kim YH, Lee SW, Son DW, Cha SH. Pituitary apoplexy following mitral valvuloplasty. J Korean Neurosurg Soc. 2015 Apr;57(4):289-91.

  12. Nawar RN, AbdelMannan D, SelmanWR, Arafah BM. Pituitary Tumor Apoplexy: A Review. J Intensive Care Med 2008;23: 75-90.

  13. Serramito-García R, García-Allut A, Arcos-Algaba AN; Castro-Bouzas D, Santín-Amo JM Gelabert-González M. Apoplejía pituitaria. Revisión del tema. Neurocirugía 2011; 22: 44-49.

  14. Elsässer PN, De Tribolet N, Lobrinus A, Gaillard RC, Portmann L, Pralong F, Gomez F. Apoplexy in Pituitary Macroadenoma. Eight Patients Presenting in 12 Months. Medicine 2005;84:188–196

  15. Mattke AF, Vender JR, Anstadt MP. Pituitary Apoplexy Presenting as Addisonian Crisis after Coronary Artery Bypass Grafting. Tex Heart Inst J 2002;29:193-9.

  16. Davies JS, Scanlon MF. Hypopituitarism after coronary artery bypass grafting. BMJ 1998;316:682–5.

  17. Pliam MB, Cohen M, Cheng L, Spaenle M, Bronstein MH, Atkin TW.Pituitary Adenomas Complicating Cardiac Surgery: Summary and Review of 11 Cases. J Card Surg 1995;10:125-132.

  18. Abbott J, Kirkby GR. Acute visual loss and pituitary apoplexy after surgery. BMJ 2004;329:218–9.

  19. Alzetani A, Fisher C, Costa R, Ohri SK. Ptosis Postcardiac Surgery: A Case of Pituitary Apoplexy. Ann Thorac Surg 2002;73:300–1.

  20. Zayour DH, Azar ST. Silent pituitary infarction after coronary artery bypass grafting procedure: case report and review of literature. Endocr Pract 2006;12:59-62.

  21. Zhang RC, Mu YF, Dong J, Lin XQ, Geng DQ. Complex effects of apoplexy secondary to pituitary adenoma. Rev Neurosci. 2017 Jan 1;28(1):59-64.

  22. Kim YH, Lee SW, Son DW, Cha SH. Pituitary apoplexy following mitral valvuloplasty. J Korean Neurosurg Soc. 2015 Apr;57(4):289-91.




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