title: Pituitary apoplexy after surgical treatment of lung cancer.
abstract: Pituitary apoplexy is a rare but potentially life-threatening condition caused by the sudden enlargement of a pituitary adenoma secondary to infarction and hemorrhage. Surgical stress is 1 cause of pituitary apoplexy, but asymptomatic pituitary adenomas are difficult to diagnose preoperatively. Here we report a case of a 78-year-old male who had postoperative pituitary apoplexy after surgery for lung cancer. He underwent right upper and middle lobectomy and lymph node dissection for squamous cell carcinoma with obstructive pneumonia. On the sixth postoperative day he developed sudden-onset fever, respiratory distress, and polyuria. Brain magnetic resonance imaging revealed an enlarged, hemorrhagic pituitary gland. He was treated with steroid hormone replacement. Subsequent endocrine hormone stress tests revealed recovery of his pituitary function. Based on his clinical course, the patient was diagnosed with acute adrenal insufficiency and diabetes insipidus due to pituitary apoplexy.
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo City, Chiba, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yoshino
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo City, Chiba, Japan. Electronic address: ysekine@tymc.twmu.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sekine
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo City, Chiba, Japan.
authors.forename: Eitetsu
authors.initials: E
authors.lastname: Koh
authors.affiliation: Department of Thoracic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo City, Chiba, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hata
authors.affiliation: Department of Diabetes and Metabolic Endocrinology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo City, Chiba, Japan.
authors.forename: Naotake
authors.initials: N
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D001706:Biopsy; D001921:Brain / Q000473:pathology; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010899:Pituitary Apoplexy / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed