A pituitary macroadenoma revealed by an ischemic stroke: a case report
K. Gorgi*a (Dr), L. Echchada (Dr), Y. Errahalia (Dr), AA. Guerbouba (Prof)
a Endocrinologie, Rabat, MOROCCO
Ischemic strokes in relation to pituitary adenomas are rare and have been described mainly in the context of pituitary apoplexy.
We report the case of a patient with a pituitary macro adenoma revealed by an ischemic stroke .
An 83 year old female patient, hypertensive for 5 years, who consulted the emergency room for a right hemiparesis of sudden onset, a cerebral MRI angio was performed showing a recent ischemic stroke paramedian left, located in the territory of the perforators of the trunk basillary, associated with an intra and supra sellar lesional process measuring 21x 14x 18 mm arriving in contact with the optic chiasma with left deviation of the pituitary stem, leuave lesions of FAZEKAS grade 2 leucoencephalopathy,
A visual field was requested and came back without any particularity, and on the endocrine level, there was no hyper secretion or hypo secretion.
The diagnosis of non-secretory macro adenoma was made and the patient was put on cabergoline 2mg/week for 3 months with reduction of tumor volume.
The management of non-functioning pituitary adenomas remains difficult in elderly subjects, especially if associated with other complications, notably stroke, hence the interest of multidisciplinary consultation in order to improve their prognosis.
The author has declared no conflict of interest.