Development of Pseudotumor Cerebri after the Removal of an Adrenocorticotropic Hormone-secreting Pituitary Adenoma

Neurosurgery ◽  
1981 ◽  
Vol 8 (6) ◽  
pp. 699-702 ◽  
Author(s):  
Neil A. Martin ◽  
John Linfoot ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Pseudotumor Cerebri ◽  
Cushing's Disease ◽  
Elevated Intracranial Pressure ◽  
Potential Complication ◽  
Computed Tomographic ◽  
Appropriate Treatment ◽  
Computed Tomographic Scan

abstract A patient with Cushing's disease developed intracranial hypertension 1 month after the removal of an adrenocorticotropic hormone-secreting pituitary adenoma. A computed tomographic scan demonstrated normal ventricles and no intracranial mass, establishing the diagnosis of pseudotumor cerebri. The elevated intracranial pressure was apparently consequent to an abrupt reduction in circulating corticosteroids. The development of pseudotumor cerebri after the correction of endogenous hypercortisolism has not been reported previously. This potential complication of the surgical treatment of Cushing's disease can be managed with prompt recognition and appropriate treatment of the syndrome.

scholarly journals Pseudotumor cerebri during Cushing's disease treatment with ketoconazole

2011 ◽  
Vol 55 (4) ◽  
pp. 284-287 ◽  
Author(s):  
Fabiola Costenaro ◽  
Ticiana C. Rodrigues ◽  
Nelson P. Ferreira ◽  
Tiago G. da Costa ◽  
Tiago Schuch ◽  
...  
Keyword(s):  
Visual Field ◽  
Intracranial Hypertension ◽  
Cushing’S Disease ◽  
Magnetic Resonance Image ◽  
Black Spot ◽  
Pseudotumor Cerebri ◽  
Cushing's Disease ◽  
Benign Intracranial Hypertension ◽  
Elevated Intracranial Pressure ◽  
Disease Treatment

Benign intracranial hypertension (Pseudotumor cerebri) has been described as related to the reduction in steroid levels in Cushing's disease (CD), especially after surgical remission. Ketoconazole is a common and effective adjuvant therapy for hypercortisolism, but the major concern is liver enzyme dysfunction. We describe here the case of a 12-year old girl with CD who developed benign intracranial hypertension during treatment with ketoconazole. She presented headache, vomiting, a black spot on her right temporal visual field, and signs of elevated intracranial pressure. Pituitary image was normal on magnetic resonance image (MRI), and all symptoms improved after treatment with acetazolamide. We call attention to the diagnosis of this disorder in CD patients, especially children on ketoconazole treatment, because it could be confounded with adrenal insufficiency and lead to definitive severe visual impairment.

Cushing's disease due to plurihormonal adrenocorticotropic hormone and gonadotropin-producing pituitary adenoma

2001 ◽  
Vol 102 (4) ◽  
pp. 398-403 ◽  
Author(s):  
R. Egensperger ◽  
B. Scheithauer ◽  
E. Horvath ◽  
K. Kovacs ◽  
C. Giannini ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Cushing's Disease

scholarly journals Progression of an Invasive ACTH Pituitary Macroadenoma with Cushing’s Disease to Pituitary Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Clarissa Groberio Borba ◽  
Rafael Loch Batista ◽  
Nina Rosa de Castro Musolino ◽  
Vanielle Carvalho Machado ◽  
Ana Elisa Evangelista Alcantara ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Pituitary Carcinoma ◽  
Cushing's Disease ◽  
Resonance Imaging ◽  
Ki 67 ◽  
P53 Expression ◽  
Acth Secreting ◽  
Pituitary Carcinomas

Pituitary carcinomas are very rare tumors that in most cases produce prolactin and adrenocorticotropic hormone (ACTH). It is a challenge to diagnosis of a pituitary carcinoma before disclosed symptomatic metastasis. We report the case of a female patient with Cushing’s disease who underwent three transsphenoidal surgeries, with pathological findings of common ACTH pituitary adenoma including Ki-67 expression <3%. She achieved hypocortisolism after the 3rd surgery although ACTH levels remained slightly elevated. The patient returned some time later with fast worsening of hypercortisolism. Magnetic resonance imaging showed clivus invasion, which led to a fourth surgery and radiation. This time, immunohistochemistry revealed strong Ki-67 (10% to 15%) and p53 expression. Liver and lumbar spine metastases were found on workup. The patient died after few months due to lung infection. Pituitary carcinomas are rare, and the transformation of an ACTH-secreting pituitary adenoma into a carcinoma is exceptional. The difficulty of defining markers for the diagnosis of carcinoma, before metastasis diagnosis, in order to change the management of the disease, is a challenge.

scholarly journals Cushing's disease: pathobiology, diagnosis, and management

2017 ◽  
Vol 126 (2) ◽  
pp. 404-417 ◽  
Author(s):  
Russell R. Lonser ◽  
Lynnette Nieman ◽  
Edward H. Oldfield
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Adrenal Glands ◽  
Early Death ◽  
Diagnostic Methods ◽  
Cushing's Disease ◽  
Biochemical Remission ◽  
Excessive Secretion ◽  
Acth Secreting

Cushing's disease (CD) is the result of excess secretion of adrenocorticotropic hormone (ACTH) by a benign monoclonal pituitary adenoma. The excessive secretion of ACTH stimulates secretion of cortisol by the adrenal glands, resulting in supraphysiological levels of circulating cortisol. The pathophysiological levels of cortisol are associated with hypertension, diabetes, obesity, and early death. Successful resection of the CD-associated ACTH-secreting pituitary adenoma is the treatment of choice and results in immediate biochemical remission with preservation of pituitary function. Accurate and early identification of CD is critical for effective surgical management and optimal prognosis. The authors review the current pathophysiological principles, diagnostic methods, and management of CD.

Cyclic Cushing's Disease in Mixed Gangliocytoma–Pituitary Adenoma Tumor: Case Report

2020 ◽  
Author(s):  
Yury Anania ◽  
Venteicher S. Andrew ◽  
Pearce M. Thomas ◽  
Gardner A. Paul
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Cushing's Disease
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