Spontaneous hemorrhagic necrosis of chromophobe adenoma with clinical presentations simulating rupture of aneurysm
Shuangshoti, S.
Journal of the Medical Association of Thailand 65(2): 95-100
1982
ISSN/ISBN: 0125-2208 PMID: 7077217 Document Number: 186042
Spontaneous hemorrhagic necrosis of a chromophobe adenoma produced sudden severe headache, persistent paresis of the left oculomotor nerve, and subarachnoid hemorrhage, but no visual loss throughout a 22-day course of ailment of a 65 yr old man. A cranial roentgenogram disclosed no clear-cut sellar enlargement. The clinical impression of rupture of an aneurysm of the left posterior communicating artery was not confirmed post mortem. The expanded suprasellar part of an 8 g chromophobe adenoma mainly projected posteriorly and to the left. The left oculomotor nerve was compressed. The optic nerves and chiasm were not affected by the tumor. Spontaneous hemorrhagic necrosis of pituitary tumors must be included in the differential diagnoses in cases of persistent palsy of the oculomotor nerve and subarachnoid hemorrhage despite the absence of visual disturbances and normal or equivocally enlarged sella turcica.