Keywords
Hypopituitarism
Chemotherapy
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Abstract
Objective: To describe a case of pituitary apoplexy after chemotherapy initiation, as well as to review the literature on the subject. Case detail: Woman, 73 years old, diagnosed with nonfunctioning pituitary macroadenoma, in addition to central hypothyroidism and borderline adrenal insufficiency. At the time, conservative initial management was chosen. One year after the diagnosis of the adenoma, the presence of an ovarian tumor with metastasis to the peritoneum and immunohistochemistry compatible with high-grade serous carcinoma was evidenced. After the second session of chemotherapy with paclitaxel and carboplatin, the patient developed headache, difficulty walking, and visual symptoms. Brain nuclear magnetic resonance imaging showed the presence of a solid intrasellar expansile lesion obliterating the suprasellar cistern and displacing the optic chiasm, with subacute intralesional hemorrhage. The patient then underwent emergency transsphenoidal surgery. Final considerations: There is an association between chemotherapy treatments with carboplatin and the development of pituitary apoplexies and consequent hypopituitarism, requiring further studies to clarify the mechanisms of cause and effect.
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