Cavernous sinus invasion might be a risk factor for apoplexy

• Published in: Pituitary 2013-12, Vol.16 (4), p.483-489
• Main Authors: Cinar, Nese, Tekinel, Yasemin, Dagdelen, Selcuk, Oruckaptan, Hakan, Soylemezoglu, Figen, Erbas, Tomris
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Cavernous Sinus - pathology; Endocrinology; Female; Human Physiology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Pituitary Apoplexy - diagnosis; Pituitary Apoplexy - drug therapy; Pituitary Apoplexy - epidemiology; Pituitary Apoplexy - physiopathology; Pituitary Neoplasms - diagnosis; Pituitary Neoplasms - drug therapy; Pituitary Neoplasms - epidemiology; Pituitary Neoplasms - physiopathology; Retrospective Studies; Risk Factors; Young Adult
• ISSN: 1386-341X; 1573-7403
• DOI: 10.1007/s11102-012-0444-2

The clinical features of pituitary hemorrhage vary from asymptomatic to catastrophic. We aimed to evaluate the frequency, symptoms, outcome and risk factors of clinical and subclinical pituitary apoplexy (PA) patients. In a retrospective analysis, charts of 547 pituitary adenoma patients from 2000 to December 2011 were reviewed. The patients were classified as clinical or subclinical PA. We compared the results with a control group without PA. Anterior pituitary hormones for endocrine dysfunction, histology, Ki-67 labeling index (LI), and p53 positivity of the tumor and pituitary imaging by magnetic resonance imaging were evaluated. Thirty-two patients (5.8 %) were diagnosed as clinical and 81 patients (14.8 %) as subclinical PA. Among PA patients, 85 patients (75.2 %) had a macroadenoma, 8 patients (7.1 %) had a microadenoma. The most frequent symptoms at presentation in PA patients were visual loss and headache. The patients with macroadenoma had a significantly increased risk for PA ( p