A Unilateral Nasal Mass With Generalized Seizures: Potential Diagnostic Pitfalls in Giant Pituitary Adenoma

Aini, Rahimah; Sachlin, Ida Sadja'ah; Chee, Lai Chuang; Abdullah, Baharudin

doi:10.1177/2152656719896580

Cited by 2 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While visual impairments and visual field defects (72%), followed by headache (13%), are the commonest preoperative presentations of these entities, seizures, particularly of the generalized tonic clonic type, are extremely rare and limited to a handful of case reports. 3,6,[8][9][10][11][12] (Table 2) Convulsions are hypothesized to occur when the tumour invades the suprasellar area and/or the nervous system, specifically the frontal and temporal lobes, generating an epileptogenic focus. 4 However, it is important to note that seizures are increasingly common in patients with prolactinomas, specifically those treated with dopamine agonists such as cabergoline and bromocriptine, as discussed in depth through multiple case studies and case series.…”

Section: Discussionmentioning

confidence: 99%

Giant Clinically Non-Functioning Pituitary Adenoma Presenting as New Onset Generalized Tonic‒Clonic Seizures: A Case Report

Weerasekara,

Chandraratne,

Perera

2024

IMCRJ

View full text Add to dashboard Cite

Background: Giant Clinically Non-Functioning Pituitary Adenomas (GCNFPA) are pituitary neuroendocrine tumours spanning beyond 4 cm in diameter without clinically apparent secretory function. They elicit insidious growth pertaining to its asymptomatic nature and present at large sizes from mass effect. Certain clinical features such as headache and visual disturbances are common presentations of GCNFPAs owing to their size, while others such as seizures are extremely rare. Case Report: A 63-year-old woman presented with back-to-back generalized tonic clonic seizures to the A&E and was treated with Levetiracetam. Following initial normal blood investigations, a visual field analysis revealed a bitemporal upper quadrantanopia and further evaluation using MRI found a giant pituitary lesion with suprasellar extension through the third ventricle into the lateral ventricles with significant mass effect. She underwent neuro-navigation guided endonasal transsphenoidal subtotal resection 2 weeks later. The histological diagnosis of null cell adenoma with a Ki67 of 3% was made. At 3 months of follow-up, she is symptom free and monitored with serial MRIs. Conclusion:Seizures are an uncommon presentation of GCNFPAs limited to a few case reports. This illustrates the importance of careful evaluation of patient presentations to correctly diagnose pituitary neoplasms and prioritizing symptom relief in choosing surgical approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

Giant Clinically Non-Functioning Pituitary Adenoma Presenting as New Onset Generalized Tonic‒Clonic Seizures: A Case Report

Weerasekara,

Chandraratne,

Perera

2024

IMCRJ

View full text Add to dashboard Cite

show abstract

Epilepsy associated with pituitary neuroendocrine tumors: Current status of problem and interdisciplinary approach

Василенко

Chudievich

Ulitin

et al. 2022

Medicinskij alfavit

View full text Add to dashboard Cite

This literature review is devoted to the problem of epilepsy caused by pituitary neuroendocrine tumors: their detailed classification with the latest recommendations of the World Health Organization 2022, clinical picture of each variant of pituitary neuroendocrine tumor in a complex multidisciplinary approach are considered. The main feature of the review is a detailed consideration of the epilepsy associated with this condition, which is considered to be a rather rare manifestation of the disease (incidence in patients is 0.5 %), due to which very few cases of epilepsy in patients with pituitary adenoma have been described in the literature. Our work has analyzed the fundamental works of domestic scientists in this field, as well as current information from foreign sources and most of the available clinical cases of epilepsy in this group of patients, revealing in detail the pathogenesis of epilepsy at all levels, including molecular changes. Modern techniques for the treatment approach in this group of patients are also described, the effectiveness of drug and surgical therapy is analyzed according to the criteria of the frequency of long-term persistent remission and recurrence, side effects of drugs and complications of transsphenoidal tumor resection are reviewed, including in terms of possible epilepsy; conclusions about the most rational and effective approach to treatment of various types of hypophysial neuroendocrine tumors are drawn.

show abstract

A Unilateral Nasal Mass With Generalized Seizures: Potential Diagnostic Pitfalls in Giant Pituitary Adenoma

Cited by 2 publications

References 6 publications

Giant Clinically Non-Functioning Pituitary Adenoma Presenting as New Onset Generalized Tonic‒Clonic Seizures: A Case Report

Giant Clinically Non-Functioning Pituitary Adenoma Presenting as New Onset Generalized Tonic‒Clonic Seizures: A Case Report

Epilepsy associated with pituitary neuroendocrine tumors: Current status of problem and interdisciplinary approach

Contact Info

Product

Resources

About