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Acute hydrocephalus as an onset form of a pituitary adenoma
Hidrocefalia aguda como forma de presentación de un adenoma hipofisario
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Neurological examination showed a <span class="elsevierStyleItalic">Glasgow Coma Scale</span> of 7 points and CT scan revealed acute hydrocephalus of both lateral ventricles (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>-A, arrows). An emergency intervention was performed and an external ventricular drain was placed. Pituitary MRI showed a voluminous 46 × 27 × 20 mm sellar mass with suprasellar extension occupying the chiasmatic cistern and partially obliterating the third ventricle with mass effect on the lateral ventricles (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>-B and <a class="elsevierStyleCrossRef" href="#fig0005">1</a>-C, arrows). The hormonal study showed gonadotropin deficiency. Endoscopic surgery was performed using a transsphenoidal approach with complete macroscopic resection. Histological study showed a pituitary adenoma with positive immunohistochemistry for cytokeratin AE1/AE2, chromogranin A and negative for all adenohypophyseal hormones <span class="elsevierStyleItalic">(null cell)</span> with Ki67 of 1%. Transient diabetes insipidus was reported as a complication.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Non-functioning pituitary adenomas are clinically manifested by their mass effect. Headache, peripheral visual disturbance and symptoms of hormone deficiency due to compression of normal pituitary tissue are the usual form of presentation. However, these symptoms went unnoticed in our patient and the large tumour growth led to acute hydrocephalus, a rare form of presentation of these tumours.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 662 "Ancho" => 2007 "Tamanyo" => 145883 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000003/v1_202308021441/S2387020623002899/v1_202308021441/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000003/v1_202308021441/S2387020623002899/v1_202308021441/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002899?idApp=UINPBA00004N" ]
