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Ectopic pituitary adenoma of the clivus presenting with apoplexy: case report and review of the literature.
MedLine Citation:
PMID:  22192701     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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:
Pamela A Mudd; Samantha Hohensee; Kevin O Lillehei; Todd T Kingdom; Bette K Kleinschmidt-Demasters
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical neuropathology     Volume:  31     ISSN:  0722-5091     ISO Abbreviation:  Clin. Neuropathol.     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2011-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214420     Medline TA:  Clin Neuropathol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  24-30     Citation Subset:  IM    
Affiliation:
From the Departments of Otolaryngology, Pathology, Neurology, and Neurosurgery, The University of Colorado Health Sciences Center, Aurora, CO, USA.
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