Pituitary Apoplexy Following Coronary Artery Bypass Grafting

Document Type : Case Report

Authors

Department of Cardiovascular surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Pituitary apoplexy following cardiac surgery is a very rare complication and can be a potentially life-threatening clinical syndrome. It could be caused by acute infarction, hemorrhage or edema and sudden enlargement of a pre-existing and unknown pituitary adenoma. We report a case of hemorrhagic apoplexy of a pituitary gland macro-adenoma successfully managed by urgent trans-sphenoidal tumor resection in a patient after elective  coronary artery bypass grafting (CABG).

Keywords


  1. Yakupoglu H, Onal MB, Civelek E, Kircelli A, Celasun B. Pituitary apoplexy after cardiac surgery in a patient with subclinical pituitary adenoma: case report with review of literature. Neurologia i neurochirurgia polska. 2010;44(5):520-5.
  2. Semenov A, Denoix E, Thiebaut M, Michon A, Pouchot J. Apoplexie hypophysaire après pontage aorto-coronarien: à propos d'une observation et revue de la littérature. La Revue de Médecine Interne. 2020 Dec 1;41(12):852-7.
  3. Hidiroglu M, Kucuker A, Ucaroglu E, Kucuker SA, Sener E. Pituitary apoplexy after cardiac surgery. The Annals of thoracic surgery. 2010 May 1;89(5):1635-7.
  4. Loubani M, Galiñanes M. Pituitary gland macroadenoma: a cause of transient blindness after cardiac surgery. The Annals of thoracic surgery. 2001 Sep 1;72(3):929-31.
  5. Kim YH, Lee SW, Son DW, Cha SH. Pituitary apoplexy following mitral valvuloplasty. Journal of Korean Neurosurgical Society. 2015 Apr 24;57(4):289-91.
  6. Franzese I, Giambruno V, Tropea I, Linardi D, Petrilli G, Faggian G. Urgent Surgery for Pituitary Adenoma Bleeding After Coronary Bypass Surgery. The Annals of Thoracic Surgery. 2020 Jul 1;110(1):e19-21.
  7. Gheorghe AM, Trandafir AI, Ionovici N, Carsote M, Nistor C, Popa FL, et al. Pituitary Apoplexy in Patients with Pituitary Neuroendocrine Tumors (PitNET). Biomedicines. 2023 Feb 23;11(3):680.
  8. Alkhaibary A, Alsubaie N, Alharbi A, Alghanim N, Khairy S, Almuntashri M, et al. Oculomotor nerve palsy following coronary artery bypass graft surgery: can pituitary apoplexy complicate the post-operative course of cardiac surgery?. Journal of Surgical Case Reports. 2021 Jul;2021(7):rjab312.