Obstructive Hydrocephalus Caused by Pituitary Adenoma: A Case Report
Affiliation(s)
Neurosugery Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neurosugery Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
ABSTRACT
Among pituitary tumors, prolactin (PRL)-secreting pituitary adenomas are by far the most frequent ones. The development of symptomatic hydrocephalus due to a pituitary adenoma is an exceptional event. The authors describe a 37-year-old man who had a pituitary adenoma associated with obstructive hydrocephalus that was managed by endoscopic transnasal transsphenoidal surgery. Postoperative CT and MRI scans showed resolution of the obstructive hydrocephalus and the foramen of Monro was open. Postoperatively, the patient had visual and headache improvement. Subsequently, the patient is a candidate for cranial surgery or medical therapy to complete the treatment. The present case highlights the fact that pituitary adenomas with obstructive hydrocephalus should be distinguished from other tumors especially colloid cysts.
KEYWORDS
PRL-Secreting Pituitary Adenomas, Transnasal Transsphenoidal Surgery, Obstructive Hydrocephalus, Cranial Surgery
PRL-Secreting Pituitary Adenomas, Transnasal Transsphenoidal Surgery, Obstructive Hydrocephalus, Cranial Surgery
Cite this paper
O.Rezaee, R.Salar, R.Jabari, and A.Shams Akhtari,(2014) Obstructive Hydrocephalus Caused by Pituitary Adenoma: A Case Report. Open Journal of Modern Neurosurgery, 4, 131-136. doi: 10.4236/ojmn.2014.43023.
O.Rezaee, R.Salar, R.Jabari, and A.Shams Akhtari,(2014) Obstructive Hydrocephalus Caused by Pituitary Adenoma: A Case Report. Open Journal of Modern Neurosurgery, 4, 131-136. doi: 10.4236/ojmn.2014.43023.
References
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http://dx.doi.org/10.1007/s11060-005-2319-0 [5] Cappabinaca, P., Cavallo, L.M., Colao, A., Del Basso De Caro, M., Esposito, F., Cirillo, S., et al. (2002) Endoscopic Endonasal Transphenoiodal Approach: Outcome Analysis of 100 Consecutive Procedures. Minimally Invasive Neurosurgery, 45, 193-200.
http://dx.doi.org/10.1055/s-2002-36197 [6] Charalampaki, P., Reisch, R., Ayad, A., Conrad, J., Welschenhold, S., Perneczky, A., et al. (2007) Endoscopic Endonasal Pituitary Surgery: Surgical and Outcome Analysis of 50 Cases. Journal of Clinical Neuroscience, 14, 410-415.
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http://dx.doi.org/10.1210/jcem.84.11.6202 [10] Molitch, M.E. (1999) Medical Treatment of Prolactinmas. Endocrinology Metabolism Clinics of North America, 28, 143-169.
http://dx.doi.org/10.1016/S0889-8529(05)70061-X [11] Losa, M., Mortini, P., Barzaghi, R., Gioia, L. and Giovanelli, M. (2002) Surgical Treatment of Prolactin-Secreting Pituitary Adenoma: Early Results and Long-Term Outcome. The Journal of Clinical Endocrinology and Metabolism, 87, 3180-3186.
http://dx.doi.org/10.1210/jcem.87.7.8645 [12] Jackson, I.M.D. and Noren, G. (1999) Role of Gamma Knife Therapy in Management of Pituitary Tumors. Endocrinology Metabolism Clinics of North America, 28, 133-142. http://dx.doi.org/10.1016/S0889-8529(05)70060-8 [13] Alfieri, A., Jho, H.D. and Tschabitscher, M. (2002) Endoscopic Endonasal Approach to the Ventral Cranio-Cervical Junction: Anatomical Study. Acta Neurochirurgica (Wien), 144, 219-225.
http://dx.doi.org/10.1007/s007010200029 [14] Bohinski, R.J., Warnich, R.E., Gaskill-Shipley, M.F., Zuccarello, M., Van Loveren, H.R., Kormos, D.W., et al. (2001) Intraoperative Magnetic Resonance Imaging to Determine the Extent of Resection of Pituitary Macroademonas during Transsphenoidal Microsurgery. Journal of Neurosurgery, 49, 1133-1144. [15] Jho, H.D. and Ha, H.G. (2004) Endoscopic Endonasal Skull Base Surgery: Part 2—The Cavernous Sinus. Minimally Invasive Neurosurgery, 47, 9-15.
http://dx.doi.org/10.1055/s-2004-818346
[1] Rotariu, D., Gaivas, S., Faiyad, Z., Iencean, A.S. and Poeata, L. (2011) Pituitary Adenoma, Therapeutic and Approach and Surgical Results. Romanian Neurosurgery, 4, 465-475. [2] Liao, A.C., Wan, S.C., Tsai, F., Chen, Y.K. and Shen, Y.Y. (2002) Incidental Pituitary Macrodenoma Detected in FDG-PET: Three Cases Report. Annals of Nuclear Medicine, 15, 211-217. [3] Thapar, K. and Kovacs, K. (1998) Tumors of the Sellar Region. In: Bigner, D.D., Mclendon, R.E. and Bruner, J.M., Eds., Russel and Rubinsteins Pathology of Tumors of the Nervous System, 6th Edition, Williams & Wilkins, Baltimore, 561. [4] Scarone, P., Losa, M., Mortini, P. and Giovanelli, M. (2006) Obstructive Hydrocephalus and Intracranial Hypertension Caused by a Giant Macroprolactinoma. Prompt Response to Medical Treatment. Journal of Neuro-Oncology, 76, 51-54.
http://dx.doi.org/10.1007/s11060-005-2319-0 [5] Cappabinaca, P., Cavallo, L.M., Colao, A., Del Basso De Caro, M., Esposito, F., Cirillo, S., et al. (2002) Endoscopic Endonasal Transphenoiodal Approach: Outcome Analysis of 100 Consecutive Procedures. Minimally Invasive Neurosurgery, 45, 193-200.
http://dx.doi.org/10.1055/s-2002-36197 [6] Charalampaki, P., Reisch, R., Ayad, A., Conrad, J., Welschenhold, S., Perneczky, A., et al. (2007) Endoscopic Endonasal Pituitary Surgery: Surgical and Outcome Analysis of 50 Cases. Journal of Clinical Neuroscience, 14, 410-415.
http://dx.doi.org/10.1016/j.jocn.2006.02.014 [7] Chole, R.A., Lim, C., Dunham, B., Chicoine, M.R. and Dacey, R.G. (2011) A Novel Transnasal Transsphenoidal Speculum: A Design for Both Microscopic and Endoscopic Transshenoidal Pituitary Surgery. Journal of Neurosurgery, 114, 1380-1385. [8] Guo, F., Li, Z., Song, L. and Liu, X. (2013) One Exceedingly Rare Co-Existence of Pituitary Adenoma with Hydrocephalus and Cerebral Aneurysm: Case Repot and Literature Review. Life Science Journal, 10, 1447-1451. [9] Ferda, P.U. and Wardlaw, S.L. (1999) Diagnosis and Treatment of Pituitary Tumors. The Journal of Clinical Endocrinology and Metabolism, 84, 3859-3866.
http://dx.doi.org/10.1210/jcem.84.11.6202 [10] Molitch, M.E. (1999) Medical Treatment of Prolactinmas. Endocrinology Metabolism Clinics of North America, 28, 143-169.
http://dx.doi.org/10.1016/S0889-8529(05)70061-X [11] Losa, M., Mortini, P., Barzaghi, R., Gioia, L. and Giovanelli, M. (2002) Surgical Treatment of Prolactin-Secreting Pituitary Adenoma: Early Results and Long-Term Outcome. The Journal of Clinical Endocrinology and Metabolism, 87, 3180-3186.
http://dx.doi.org/10.1210/jcem.87.7.8645 [12] Jackson, I.M.D. and Noren, G. (1999) Role of Gamma Knife Therapy in Management of Pituitary Tumors. Endocrinology Metabolism Clinics of North America, 28, 133-142. http://dx.doi.org/10.1016/S0889-8529(05)70060-8 [13] Alfieri, A., Jho, H.D. and Tschabitscher, M. (2002) Endoscopic Endonasal Approach to the Ventral Cranio-Cervical Junction: Anatomical Study. Acta Neurochirurgica (Wien), 144, 219-225.
http://dx.doi.org/10.1007/s007010200029 [14] Bohinski, R.J., Warnich, R.E., Gaskill-Shipley, M.F., Zuccarello, M., Van Loveren, H.R., Kormos, D.W., et al. (2001) Intraoperative Magnetic Resonance Imaging to Determine the Extent of Resection of Pituitary Macroademonas during Transsphenoidal Microsurgery. Journal of Neurosurgery, 49, 1133-1144. [15] Jho, H.D. and Ha, H.G. (2004) Endoscopic Endonasal Skull Base Surgery: Part 2—The Cavernous Sinus. Minimally Invasive Neurosurgery, 47, 9-15.
http://dx.doi.org/10.1055/s-2004-818346