Limits...
Developed diplopia and ptosis due to a nonfunctioning pituitary macroadenoma during pregnancy.

Lee HR, Song JE, Lee KY - Obstet Gynecol Sci (2014)

Bottom Line: Notwithstanding the medication of bromocriptine, her symptoms did not regress during pregnancy.At 5 months after delivery, her symptoms dramatically resolved without any surgery, and her visual acuity was normalized.Her MRI scan also revealed more decreased size of pituitary gland compared to antenatal MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hallym University College of Medicine, Seoul, Korea.

ABSTRACT
Physiologic pituitary enlargement is common during normal pregnancy. However, symptoms such as diplopia, blurred vision and headache resulting from physiologic pituitary enlargement are very rare during pregnancy. A 39-year-old woman complained of sudden diplopia and left eye ptosis at 33th weeks of gestation. An magnetic resonance imaging (MRI) demonstrated the pituitary enlargement compressing the optic chiasm. Notwithstanding the medication of bromocriptine, her symptoms did not regress during pregnancy. At 5 months after delivery, her symptoms dramatically resolved without any surgery, and her visual acuity was normalized. Her MRI scan also revealed more decreased size of pituitary gland compared to antenatal MRI. We report a case of visual loss due to the physiologic pituitary enlargement of nonfunctioning adenoma during pregnancy, which regressed spontaneously after delivery without any surgery.

No MeSH data available.


Related in: MedlinePlus

Pituitary magnetic resonance imaging at pregnancy 34 weeks revealed a large pituitary mass with a height of 1.5 cm and compression of the optic chiasm. Arrows indicate the pituitary mass. (A) Sagittal view. (B) Coronal view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3924742&req=5

Figure 1: Pituitary magnetic resonance imaging at pregnancy 34 weeks revealed a large pituitary mass with a height of 1.5 cm and compression of the optic chiasm. Arrows indicate the pituitary mass. (A) Sagittal view. (B) Coronal view.

Mentions: A 39-year-old iparous women visited our institution at 34th weeks of gestation with 1-week history of sudden diplopia and left ptosis. After a review by the obstetrician, she was admitted to the high risk pregnancy unit. We consulted neurologist, endocrinologist and ophthalmologist for a review. She had relatively regular menstruation cycle before pregnancy. Therefore, she had not been examined any evaluations for pituitary gland or pituitary hormones before pregnancy. There were no specific past medical or operative histories. Neurologic examination revealed the limitation of her left eye movement to the medial, superior and inferior directions. Magnetic resonance imaging (MRI) demonstrated a macroadenoma with the size of 1.5×1.3×1.0 cm, which was lobulated with suprasellar extension and compression of the optic chiasm. It encased the left cavernous sinus and internal carotid artery (Fig. 1). The narrowing of internal carotid artery by the tumor caused the third nerve palsy. Endocrine tests indicated that prolactin, cortisol and estriol (E2) levels were elevated: prolactin was 176.3 ng/mL; cortisol was at 36.0 µg/dL; E2 was >1,000 pg/mL. There were no features of diabetes insipidus. Serum electrolytes and paired serum/urine osmolalities were within normal limits. Obstetric ultrasound revealed a live singleton fetus weighing 2,390 g with vertex presentation and a 4.7 cm sized myomatous nodule on anterior uterine body.


Developed diplopia and ptosis due to a nonfunctioning pituitary macroadenoma during pregnancy.

Lee HR, Song JE, Lee KY - Obstet Gynecol Sci (2014)

Pituitary magnetic resonance imaging at pregnancy 34 weeks revealed a large pituitary mass with a height of 1.5 cm and compression of the optic chiasm. Arrows indicate the pituitary mass. (A) Sagittal view. (B) Coronal view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924742&req=5

Figure 1: Pituitary magnetic resonance imaging at pregnancy 34 weeks revealed a large pituitary mass with a height of 1.5 cm and compression of the optic chiasm. Arrows indicate the pituitary mass. (A) Sagittal view. (B) Coronal view.
Mentions: A 39-year-old iparous women visited our institution at 34th weeks of gestation with 1-week history of sudden diplopia and left ptosis. After a review by the obstetrician, she was admitted to the high risk pregnancy unit. We consulted neurologist, endocrinologist and ophthalmologist for a review. She had relatively regular menstruation cycle before pregnancy. Therefore, she had not been examined any evaluations for pituitary gland or pituitary hormones before pregnancy. There were no specific past medical or operative histories. Neurologic examination revealed the limitation of her left eye movement to the medial, superior and inferior directions. Magnetic resonance imaging (MRI) demonstrated a macroadenoma with the size of 1.5×1.3×1.0 cm, which was lobulated with suprasellar extension and compression of the optic chiasm. It encased the left cavernous sinus and internal carotid artery (Fig. 1). The narrowing of internal carotid artery by the tumor caused the third nerve palsy. Endocrine tests indicated that prolactin, cortisol and estriol (E2) levels were elevated: prolactin was 176.3 ng/mL; cortisol was at 36.0 µg/dL; E2 was >1,000 pg/mL. There were no features of diabetes insipidus. Serum electrolytes and paired serum/urine osmolalities were within normal limits. Obstetric ultrasound revealed a live singleton fetus weighing 2,390 g with vertex presentation and a 4.7 cm sized myomatous nodule on anterior uterine body.

Bottom Line: Notwithstanding the medication of bromocriptine, her symptoms did not regress during pregnancy.At 5 months after delivery, her symptoms dramatically resolved without any surgery, and her visual acuity was normalized.Her MRI scan also revealed more decreased size of pituitary gland compared to antenatal MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hallym University College of Medicine, Seoul, Korea.

ABSTRACT
Physiologic pituitary enlargement is common during normal pregnancy. However, symptoms such as diplopia, blurred vision and headache resulting from physiologic pituitary enlargement are very rare during pregnancy. A 39-year-old woman complained of sudden diplopia and left eye ptosis at 33th weeks of gestation. An magnetic resonance imaging (MRI) demonstrated the pituitary enlargement compressing the optic chiasm. Notwithstanding the medication of bromocriptine, her symptoms did not regress during pregnancy. At 5 months after delivery, her symptoms dramatically resolved without any surgery, and her visual acuity was normalized. Her MRI scan also revealed more decreased size of pituitary gland compared to antenatal MRI. We report a case of visual loss due to the physiologic pituitary enlargement of nonfunctioning adenoma during pregnancy, which regressed spontaneously after delivery without any surgery.

No MeSH data available.


Related in: MedlinePlus