Pituitary apoplexy in a puberal child: A case report and review of the literature

Abstract

Pituitary apoplexy is extremely rare in children and adolescents. A case of an 11-year-old pubertal female with complaints of intermittent holocranial headaches for 4 months, with progressive visual disturbances, who presented to the emergency department after the sudden onset of a thunderclap headache and acute deterioration in right eye vision, is presented. On laboratory investigation, her prolactin level was higher than 1000 ng/mL. Magnetic resonance imaging showed a sellar mass with suprasellar extension and characteristics of hemorrhage within it. The patient underwent emergency endoscopic endonasal transsphenoidal decompression of the tumor. Postoperatively, the patient recovered well, with improvement in right eye vision and a decrease in the prolactin level to normal. She was discharged on hormone replacement therapy. A literature review showed that only 21 patients with clinical pituitary apoplexy in the age group younger than 20 years have been reported since 1980 after the advent of CT; the present patient is the 22nd and the youngest patient with clinical pituitary apoplexy.

Keywords

• Clinical pituitary apoplexy
• Puberal child
• Youngest patient
• Prolactinoma