Clinical management of apoplexy in non-functioning pituitary macroadenoma during pregnancy: A case report

Abstract

Pituitary apoplexy is a rare event, especially in pregnancy, with few cases reported in the literature. It occurs secondary to hemorrhagic infarcts due to vascular changes in a pituitary tumor. It may manifest with hormonal changes when secondary to functioning tumors or with neurological symptoms when it exerts mass effect in the case of non-functioning tumors. The diagnosis is based on clinical suspicion, mainly in the presence of symptoms suggesting mass effect with neurological and visual involvement. Studies such as hormone function tests and brain MRI are tools to confirm the pathology. We describe the case of a 30-year-old patient with a 28-week pregnancy who presented headache associated with visual symptoms that progressed during gestation, with a diagnosis of pituitary apoplexy, the clinical approach and management options that sought to preserve fetal viability and maternal integrity are presented.