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Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment.
BMJ Case Rep. 2022 Mar 07; 15(3)BC

Abstract

Pituitary apoplexy (PA) is a clinical condition characterised by a sudden increase in pituitary gland volume secondary to ischaemia and/or necrosis. Most cases occur in non-functioning pituitary adenoma but can also occur in functioning adenoma. Certain predisposing factors can result in PA and the use of gonadotropin-releasing hormone (GnRH) agonists for prostate cancer (PCa) is one such condition. Once diagnosed, both surgical and conservative management has been used for the treatment of PA. We present a case of a man in his late 50s who developed PA following treatment of PCa with leuprolide. His symptoms developed insidiously and he presented 6 months after symptom onset. Anterior pituitary hormone workup along with pituitary MRI confirmed the diagnosis of PA and patient was subsequently treated with adequate replacement of pituitary hormone with significant improvement in his symptoms. It is very important to keep a high index of suspicion for PA, especially among elderly patients receiving GnRH agonist treatment for PCa.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Elshimy G
Endocrinology, Augusta University Medical College of Georgia, Augusta, Georgia, USA.
Raj R
Endocrinology, Diabetes and Metabolism, Pikeville Medical Center, Pikeville, Kentucky, USA rishiraj91215@gmail.com. Endocrinology, Diabetes and Metabolism, University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, Kentucky, USA.
Jacob A
Hematology and Oncology, Pikeville Medical Center, Pikeville, Kentucky, USA.
Correa R
Endocrinology, Diabetes and Metabolism, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA.

MeSH

AgedGonadotropin-Releasing HormoneHumansLeuprolideMalePituitary ApoplexyPituitary NeoplasmsProstatic Neoplasms

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

35256375

Citation

Elshimy, Ghada, et al. "Late Onset of Pituitary Apoplexy Following Gonadotropin-releasing Hormone Agonist for Prostate Cancer Treatment." BMJ Case Reports, vol. 15, no. 3, 2022.
Elshimy G, Raj R, Jacob A, et al. Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment. BMJ Case Rep. 2022;15(3).
Elshimy, G., Raj, R., Jacob, A., & Correa, R. (2022). Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment. BMJ Case Reports, 15(3). https://doi.org/10.1136/bcr-2021-248523
Elshimy G, et al. Late Onset of Pituitary Apoplexy Following Gonadotropin-releasing Hormone Agonist for Prostate Cancer Treatment. BMJ Case Rep. 2022 Mar 7;15(3) PubMed PMID: 35256375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment. AU - Elshimy,Ghada, AU - Raj,Rishi, AU - Jacob,Aasems, AU - Correa,Ricardo, Y1 - 2022/03/07/ PY - 2024/03/07/pmc-release PY - 2022/3/8/entrez PY - 2022/3/9/pubmed PY - 2022/3/11/medline KW - endocrine system KW - malignant disease and immunosuppression KW - pituitary disorders KW - prostate cancer KW - unwanted effects / adverse reactions JF - BMJ case reports JO - BMJ Case Rep VL - 15 IS - 3 N2 - Pituitary apoplexy (PA) is a clinical condition characterised by a sudden increase in pituitary gland volume secondary to ischaemia and/or necrosis. Most cases occur in non-functioning pituitary adenoma but can also occur in functioning adenoma. Certain predisposing factors can result in PA and the use of gonadotropin-releasing hormone (GnRH) agonists for prostate cancer (PCa) is one such condition. Once diagnosed, both surgical and conservative management has been used for the treatment of PA. We present a case of a man in his late 50s who developed PA following treatment of PCa with leuprolide. His symptoms developed insidiously and he presented 6 months after symptom onset. Anterior pituitary hormone workup along with pituitary MRI confirmed the diagnosis of PA and patient was subsequently treated with adequate replacement of pituitary hormone with significant improvement in his symptoms. It is very important to keep a high index of suspicion for PA, especially among elderly patients receiving GnRH agonist treatment for PCa. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/35256375/Late_onset_of_pituitary_apoplexy_following_gonadotropin_releasing_hormone_agonist_for_prostate_cancer_treatment_ DB - PRIME DP - Unbound Medicine ER -