Last update:
04-Jan-2001

Arch Hellen Med, 17(4), July-August 2000, 395-398

SHORT COMMUNICATION

Pituitary non-secreting macroadenoma apoplexy in an adolescent

E. TZEMANAKIS,¹ S.P. DOURAKIS,¹ B. ATHANASIOU,² G. TOLIS^2
1Academic Department of Medicine
²Department of Endocrinology Hippokration General Hospital, Athens, Greece

Pituitary macroadenoma is rare in pediatric and adolescent populations and is usually hormonally functional. Symptomatic pituitary non-secreting macroadenoma apoplexy in an adolescent is a rare life-threatening event. The case is described of an adolescent with a four-day history of headache, fever and photophobia. A meningeal syndrome was postulated on clinical grounds and examination of the cerebrospinal fluid. Following clinical examination and hormone tests, a partial failure of the anterior pituitary was detected. The brain CT scan revealed a space-occuping lesion of the pituitary and on magnetic resonance imaging, a pituitary macroadenoma was suggested. Hypophysectomy was performed and histological examination showed an infarct of a non-functioning macroadenoma. Hormonal substitution with thyroxine and steroids was prescribed. In conclusion, pituitary non-secreting macroadenoma apoplexy may be the diagnosis in an adolescent with headache and fever. A high index of clinical suspicion is necessary for its differentiation from acute meningitis.

Key words: Adolescent, Pituitary adenoma, Pituitary apoplexy, Pituitary deficiency.