Tags

Type your tag names separated by a space and hit enter

Delayed pituitary apoplexy in patient with advanced prostate cancer treated with gonadotrophin-releasing hormone agonists.
J Clin Neurosci. 2010 Sep; 17(9):1201-3.JC

Abstract

Gonadotrophin-releasing hormone agonists (GnRHAs) are used in many clinical conditions, particularly prostate cancer. There have been a few case reports of apoplexy from a previously undiagnosed pituitary tumour, occurring within hours to days of initiation of GnRHA therapy. We report a case of delayed onset pituitary apoplexy following GnRHA therapy. A 71-year-old man presented three weeks after onset of headache and vision loss. On examination, he was blind in the right eye with an intact nasal field of vision in the left eye. Two months before presentation, he had a subcutaneous GnRHA (Goserelin) implant for treatment of locally advanced prostate cancer (Gleeson 4+3). An MRI scan revealed a large sellar/suprasellar mass. His follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were grossly elevated. A trans-sphenoidal endoscopic decompression of the pituitary tumour was performed. His vision improved post-operatively and his FSH, LH, testosterone, prostate specific antigen (PSA) levels returned to normal levels. Histopathologic studies revealed a pituitary adenoma, which stained positive for FSH and LH. The prostate cancer management was changed to an anti-androgen agent and a GnRH antagonist. This case demonstrates that pituitary apoplexy can develop up to eight weeks after the initiation of treatment for prostate cancer with GnRHAs.

Links

Publisher Full Text
Aggregator Full Text

Authors+Show Affiliations

Sinnadurai M
Department of Neurosurgery, Wollongong Hospital, Wollongong, New South Wales, Australia. msinnadu@med.usyd.edu.au
Cherukuri RK
No affiliation info available
Moses RG
No affiliation info available
Nasser E
No affiliation info available

MeSH

AgedDrug ImplantsGonadotropin-Releasing HormoneGoserelinHumansMalePituitary ApoplexyProstatic NeoplasmsTime Factors

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20605467

Citation

Sinnadurai, M, et al. "Delayed Pituitary Apoplexy in Patient With Advanced Prostate Cancer Treated With Gonadotrophin-releasing Hormone Agonists." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 17, no. 9, 2010, pp. 1201-3.
Sinnadurai M, Cherukuri RK, Moses RG, et al. Delayed pituitary apoplexy in patient with advanced prostate cancer treated with gonadotrophin-releasing hormone agonists. J Clin Neurosci. 2010;17(9):1201-3.
Sinnadurai, M., Cherukuri, R. K., Moses, R. G., & Nasser, E. (2010). Delayed pituitary apoplexy in patient with advanced prostate cancer treated with gonadotrophin-releasing hormone agonists. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 17(9), 1201-3. https://doi.org/10.1016/j.jocn.2010.01.012
Sinnadurai M, et al. Delayed Pituitary Apoplexy in Patient With Advanced Prostate Cancer Treated With Gonadotrophin-releasing Hormone Agonists. J Clin Neurosci. 2010;17(9):1201-3. PubMed PMID: 20605467.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed pituitary apoplexy in patient with advanced prostate cancer treated with gonadotrophin-releasing hormone agonists. AU - Sinnadurai,M, AU - Cherukuri,R K, AU - Moses,R G, AU - Nasser,E, Y1 - 2010/06/03/ PY - 2009/10/19/received PY - 2009/12/27/revised PY - 2010/01/04/accepted PY - 2010/7/8/entrez PY - 2010/7/8/pubmed PY - 2011/2/1/medline SP - 1201 EP - 3 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 17 IS - 9 N2 - Gonadotrophin-releasing hormone agonists (GnRHAs) are used in many clinical conditions, particularly prostate cancer. There have been a few case reports of apoplexy from a previously undiagnosed pituitary tumour, occurring within hours to days of initiation of GnRHA therapy. We report a case of delayed onset pituitary apoplexy following GnRHA therapy. A 71-year-old man presented three weeks after onset of headache and vision loss. On examination, he was blind in the right eye with an intact nasal field of vision in the left eye. Two months before presentation, he had a subcutaneous GnRHA (Goserelin) implant for treatment of locally advanced prostate cancer (Gleeson 4+3). An MRI scan revealed a large sellar/suprasellar mass. His follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were grossly elevated. A trans-sphenoidal endoscopic decompression of the pituitary tumour was performed. His vision improved post-operatively and his FSH, LH, testosterone, prostate specific antigen (PSA) levels returned to normal levels. Histopathologic studies revealed a pituitary adenoma, which stained positive for FSH and LH. The prostate cancer management was changed to an anti-androgen agent and a GnRH antagonist. This case demonstrates that pituitary apoplexy can develop up to eight weeks after the initiation of treatment for prostate cancer with GnRHAs. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/20605467/Delayed_pituitary_apoplexy_in_patient_with_advanced_prostate_cancer_treated_with_gonadotrophin_releasing_hormone_agonists_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(10)00148-7 DB - PRIME DP - Unbound Medicine ER -