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September 1974

Pituitary Apoplexy in Acromegaly Followed by Partial Pituitary Insufficiency

Author Affiliations

From the departments of medicine (Drs. Jacobi and Fishman) and neurology (Dr. Daroff), University of Miami School of Medicine, and the medical and neurology services, Veterans Administration Hospital, Miami, Fla.

Arch Intern Med. 1974;134(3):559-561. doi:10.1001/archinte.1974.00320210169027

Pituitary apoplexy in a neuroendocrine emergency resulting from rapid enlargement of infarction of a hypophysial tumor.1 The provoking pathologic processes within the tumor may be hemorrhage, hemorrhagic infarction, or necrosis. The mortality of patients with pituitary apoplexy in various collected series is of the order of 45%,2-4 with about 15% of patients recovering spontaneously. The high mortality in this syndrome is in part related to failure of its prompt recognition, the frequently poor general status of the patients, and unnecessary delay in surgical intervention.1,2

Although pituitary apoplexy has been more commonly reported with chromophobe adenomas, it appears to occur with disproportionate frequency in the less-common eosinophilic adenomas.5 Taylor et al6 in 1968 reviewed 26 cases of well-documented pituitary apoplexy occurring in acromegaly and four more patients have been described since.7-9 Study of the endocrine status of acromegalic patients surviving this catastrophe, however, has been

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