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Ectopic pituitary adenoma of the clivus presenting with apoplexy: case report and review of the literature.
Clin Neuropathol. 2012 Jan-Feb; 31(1):24-30.CN

Abstract

Ectopic pituitary adenomas usually occur within sphenoid sinus or nasopharynx, and seldom within the clivus. There is only a single reported example of ectopic adenoma with clinical apoplexy, albeit not from clivus. We report a 78-year-old male with known prostate carcinoma admitted with acute onset of blurred vision, suggestive of apoplexy. Work-up revealed unilateral cranial nerve VI palsy and neuroimaging showed a mass confined to the clivus; sellar region was normal. Preoperative considerations included chordoma, chondrosarcoma, or metastatic prostate carcinoma to bone. Resection was via endoscopic transsphenoidal approach to the clivus. An ectopic null cell pituitary adenoma with bland infarction was identified as the cause of the patient's clinical apoplexy. No antecedent precipitating factors for apoplexy were present; specifically the patient had not received leuprolide preoperatively, a known precipitant of pituitary apoplexy in prostate cancer patients who receive drug. We review the literature on ectopic clival pituitary adenomas, apoplexy in ectopic adenomas, and the link between apoplexy and leuprolide usage.

Authors+Show Affiliations

Departments of Otolaryngology, Pathology, Neurology, and Neurosurgery, The University of Colorado Health Sciences Center, Aurora, CO 80262, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22192701

Citation

Mudd, Pamela A., et al. "Ectopic Pituitary Adenoma of the Clivus Presenting With Apoplexy: Case Report and Review of the Literature." Clinical Neuropathology, vol. 31, no. 1, 2012, pp. 24-30.
Mudd PA, Hohensee S, Lillehei KO, et al. Ectopic pituitary adenoma of the clivus presenting with apoplexy: case report and review of the literature. Clin Neuropathol. 2012;31(1):24-30.
Mudd, P. A., Hohensee, S., Lillehei, K. O., Kingdom, T. T., & Kleinschmidt-Demasters, B. K. (2012). Ectopic pituitary adenoma of the clivus presenting with apoplexy: case report and review of the literature. Clinical Neuropathology, 31(1), 24-30.
Mudd PA, et al. Ectopic Pituitary Adenoma of the Clivus Presenting With Apoplexy: Case Report and Review of the Literature. Clin Neuropathol. 2012 Jan-Feb;31(1):24-30. PubMed PMID: 22192701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ectopic pituitary adenoma of the clivus presenting with apoplexy: case report and review of the literature. AU - Mudd,Pamela A, AU - Hohensee,Samantha, AU - Lillehei,Kevin O, AU - Kingdom,Todd T, AU - Kleinschmidt-Demasters,Bette K, PY - 2011/12/24/entrez PY - 2011/12/24/pubmed PY - 2012/3/9/medline SP - 24 EP - 30 JF - Clinical neuropathology JO - Clin Neuropathol VL - 31 IS - 1 N2 - Ectopic pituitary adenomas usually occur within sphenoid sinus or nasopharynx, and seldom within the clivus. There is only a single reported example of ectopic adenoma with clinical apoplexy, albeit not from clivus. We report a 78-year-old male with known prostate carcinoma admitted with acute onset of blurred vision, suggestive of apoplexy. Work-up revealed unilateral cranial nerve VI palsy and neuroimaging showed a mass confined to the clivus; sellar region was normal. Preoperative considerations included chordoma, chondrosarcoma, or metastatic prostate carcinoma to bone. Resection was via endoscopic transsphenoidal approach to the clivus. An ectopic null cell pituitary adenoma with bland infarction was identified as the cause of the patient's clinical apoplexy. No antecedent precipitating factors for apoplexy were present; specifically the patient had not received leuprolide preoperatively, a known precipitant of pituitary apoplexy in prostate cancer patients who receive drug. We review the literature on ectopic clival pituitary adenomas, apoplexy in ectopic adenomas, and the link between apoplexy and leuprolide usage. SN - 0722-5091 UR - https://www.unboundmedicine.com/medline/citation/22192701/Ectopic_pituitary_adenoma_of_the_clivus_presenting_with_apoplexy:_case_report_and_review_of_the_literature_ L2 - http://www.dustri.com/nc/journals-in-english.html?artId=9317 DB - PRIME DP - Unbound Medicine ER -