title: Spontaneous remission of functioning pituitary adenomas without hypopituitarism following infarctive apoplexy: two case reports.
abstract: Functioning pituitary adenomas may exhibit spontaneous remission after pituitary apoplexy usually in association with hypopituitarism. We report two patients who presented with sudden headache and double vision, showed a ring-enhanced sellar tumor on MRI, underwent transsphenoidal surgery that revealed a coagulation necrotic adenoma without massive hemorrhage, and showed normal pituitary function after the surgery. Definitive diagnoses were made based on immunohistochemistry of the necrotic cells. The findings were consistent with the presence of selective infarct of a GH adenoma and a prolactinoma that had led to remission of acromegaly and menstrual disturbance, respectively, without pituitary insufficiency. In contrast to hemorrhagic apoplexy, infarctive apoplexy tends to affect only the tumor and thus presents with mild symptoms and lack pituitary deficiencies.
authors.affiliation: Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishioka
authors.forename: Jo
authors.initials: J
authors.lastname: Haraoka
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000172:Acromegaly / Q000209:etiology; D000236:Adenoma / Q000098:blood supply* / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007238:Infarction / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000503:physiopathology*; D010911:Pituitary Neoplasms / Q000098:blood supply* / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D011184:Postoperative Period; D015175:Prolactinoma / Q000098:blood supply / Q000503:physiopathology; D012075:Remission, Spontaneous
chemical_list: D019382:Human Growth Hormone