Extensive Pituitary Apoplexy after Chemotherapy in a Patient with Metastatic Breast Cancer.

Author: Je Hun JANG ¹ ; Young San KO ; Eun Kyeong HONG ; Ho Shin GWAK
Author Information

1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
Publication Type:Case Report
Keywords: Breast cancer; Chemotherapy; Pituitary adenoma; Pituitary apoplexy; Necrosis
MeSH: Adult; Breast Neoplasms*; Breast*; Bromocriptine; Drug Therapy*; Female; Headache; Hemorrhage; Humans; Necrosis; Neuroimaging; Pituitary Apoplexy*; Pituitary Neoplasms; Precipitating Factors; Pregnancy; Visual Acuity
From:Brain Tumor Research and Treatment 2018;6(1):43-46
CountryRepublic of Korea
Language:English
Abstract: Surgery, anticoagulation therapy, pregnancy, and hormone treatments, such as bromocriptine, are well-characterized precipitating factors for pituitary apoplexy. However, whether cytotoxic chemotherapy for systemic cancer could cause pituitary apoplexy has not been investigated. Here, we present a case of a 41-year-old woman who developed a severe headache with decreased visual acuity after intravenous cytotoxic chemotherapy to treat metastatic breast cancer. Preoperative neuroimaging revealed pituitary adenoma with necrosis. Operative findings and pathologic examination concluded extensive necrosis with a small intratumoral hemorrhage in a pre-existing pituitary adenoma. We reviewed two additional previously published cases of pituitary apoplexy after systemic chemotherapy and suggest that cytotoxic chemotherapy may induce pituitary apoplexy.