Pituitary macroadenoma presenting with pituitary apoplexy, acromegaly and secondary diabetes mellitus - a case report.
Pituitary adenomas are associated with significant morbidity. The usual symptoms on presentation are of endocrine dysfunction and mass effects. A 31-year-old African female presented with headache, irregular menses, blurring of vision in the right eye and complete loss of vision in the left eye for 1 year. She had coarse facial features, enlarged hands and feet. Her right eye had temporal hemianopia with decreased visual acuity and her left eye had no perception of light. Investigations revealed an elevated fasting blood sugar and an elevated prolactin and growth hormone level. A CT scan and MRI done showed a hemorrhagic pituitary macroadenoma. She was put on bromocriptine, ocreotide, analgesics and insulin. Thereafter, she underwent transphenoidal surgery, where near total resection of the tumor was achieved. Patient is doing well post-operatively. This case highlights the importance of the use of a high clinical index of suspicion and radiological findings in diagnosis.
University of Nairobi, Medical Officer, Outpatient department, Consolata Hospital, Nyeri, Kenya.
Hudson Kamau
HK
Nganga
Reuben Paul
RP
Lubanga
D000172:Acromegaly / Q000175:diagnosis / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010899:Pituitary Apoplexy / Q000175:diagnosis / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity
CT scan; MRI; Pitutary macroadenoma; acromegaly; diabetes mellitus