Undifferentiated patient recipıenting home care service: Pituitary insufficiency due to pituitary adenoma
Pituitary adenomas are mostly benign tumors arising from the pituitary gland. Diagnosis is made by MRI and hormone levels. Apart from prolactinomas, the first and most effective treatment of adenomas with compression findings is surgery. An 83-year-old female patient was requested to be examined from home care services. It was learned that she had complaints of fatigue, weakness, difficulty in walking, constipation and sometimes fluctuations in consciousness for 1 week. Thyroid function tests were also requested due to the patient’s complaints of fatigue, weakness and constipation. Despite the low fT3 and fT4 values, the normal values of TSH made us think of a pathology originating from the pituitary gland and made us consult the endocrinology. Considering that the patient might have a pituitary insufficiency, pituitary MRI was requested. In the pituitary MRI: A mass of approximately 23*17.5 mm in size at its widest part, consistent with a macroadenoma, was observed. The patient was admitted to the internal medicine service by virtue of pituitary insufficiency due to macroadenoma. We aimed to present our case to draw attention to the fact that family medicine often encounters patients with unresolved patients and undifferentiated diseases that have not been evaluated or classified by a physician before. Key wordles: Pituitary adenomas, pituitary insufficiency, undifferentiated diseases.
References
- Gounden V, Jialal I. Hypopituitarism (panhypopituitarism). StatPearl Publishing, 2021. https://www.ncbi.nlm. nih.gov/books/NBK470414/ adresinden 15.02.2022 tarihinde erişilmiştir.
- Patıroğlu T. Endokrin sistem patolojisi. Kayseri, Erciyes Üniversitesi Yayınları. 1995: 24.
- Moreno CS, Evans CO. et al. Novel molecular signaling and classification of human clinically nonfunctional pituitary adenomas identified by gene expression profiling and proteomic analyses. Cancer Res 2005;65(22):10214 -22.
- Gsponer J, De Tribolet N, Déruaz JP, Janzer R, Uské A, Mirimanoff RO et al. Diagnosis, treatment, and outcome of pituitary tumors and other abnormal intrasellar masses: retrospective analysis of 353 patients. Medicine 1999;78(4):236 – 69.
- Losa M, Mortini P, Barzaghi R, Rıbotto P, Terreni MR, Marzoli SB et al. Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J Neurosurg 2008;108:525-32.