What are the possible complications of pituitary macroadenomas?

Updated: Mar 23, 2018
  • Author: James R Mulinda, MD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Complications result from mass effects and abnormal hormone function. [27]

Pituitary apoplexy, which is an acute hemorrhagic infarction of a pituitary tumor, requires emergency decompression. It presents with adrenal crisis and a severe headache followed by coma and death within hours if not appropriately managed.

Postoperatively, pituitary hormone insufficiency, including diabetes insipidus, hypothyroidism, and hypogonadism, may occur. [28]

Radiation treatment exceeding 60 Gy can be associated with optic nerve neuropathy and brain necrosis.

Pituitary hormone insufficiency might present several years after treatment.

Other complications include visual impairment, obesity, and memory impairment.

Pregnancy is associated with hyperprolactinemia. Treatment for hyperprolactinemia should be withheld unless the sudden increase is suggestive of a marked increase in the size of the tumor. Pregnancy is also associated with lymphocytic hypophysitis, an autoimmune inflammatory lesion of the pituitary that often presents with adrenal insufficiency.


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