Pituitary Apoplexy Associated with Endocrine Stimulation Test: Endocrine Stimulation Test, Treatment, and Outcome

Table 1

(a) Reported cases of pituitary apoplexy associated with endocrine stimulation test: diagnosis, extension, and stimulation test

Case no.	Author	Year	Age/sex	Diagnosis	Extension	Stimulation test
1	Dunn et al.	1975	22/F	GH secreting	Uncertain	TRH, glucose, insulin
2	Silverman et al.	1978	31/M	PRL secreting	Extrasellar extension	Chlorpromazine
3	Jordan et al.	1979	21/F	ACTH secreting	Uncertain	Dexamethasone
4	Cimino et al.	1981	48/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH
5	Drury et al.	1982	59/F	Nonfunctioning	Extrasellar extension	TRH, LH-RH, glucagon
6	Drury et al.	1982	66/M	GH secreting	Intrasellar	TRH
7	Drury et al.	1982	39/F	PRL secreting	Extrasellar extension	TRH, LH-RH
8	Drury et al.	1982	28/M	PRL secreting	Extrasellar extension	TRH, LH-RH
9	Bernstein et al.	1984	48/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH, insulin
10	Korsic	1994	56/M	FSH secreting	Extrasellar extension	LH-RH
11	Chapman et al.	1979	39/F	PRL secreting	Extrasellar extension	TRH, LH-RH, insulin
12	Lever et al.	1986	19/F	GH secreting	Intrasellar	TRH
13	Shirataki et al.	1988	50/F	GH secreting	Extrasellar extension	Bromocriptine
14	Harvey et al.	1989	50/M	Nonfunctioning	Uncertain	Insulin
15	Arafah et al.	1990	41/F	PRL secreting	Extrasellar extension	LH-RH
16	Masson et al.	1993	54/F	FSH secreting	Extrasellar extension	LH-RH
17	Okuda et al.	1994	60/F	Nonfunctioning	Extrasellar extension	TRH, LH-RH, insulin
18	Vassallo et al.	1994	81/M	Nonfunctioning	Uncertain	TRH, LH-RH, L-Dopa
19	Masago et al.	1995	48/M	FSH secreting	Extrasellar extension	TRH, LH-RH, insulin
20	Masago et al.	1995	54/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH
21	Szabolcs et al.	1997	54/M	Nonfunctioning	Extrasellar extension	TRH
22	Otsuka et al.	1998	31/F	GH secreting	Extrasellar extension	GRF, TRH, LH-RH, CRH
23	Dökmetaş et al.	1999	28/F	GH secreting	Extrasellar extension	TRH
24	Sanno et al.	1999	55/M	Nonfunctioning	Extrasellar extension	GRF, TRH, LH-RH, CRH
25	Lee et al.	2000	34/M	GH secreting	Extrasellar extension	TRH, LH-RH, insulin
26	Riedl et al.	2000	71/F	Nonfunctioning	Extrasellar extension	GRF, TRH, LH-RH, CRH
27	Matsuura et al.	2001	63/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH, insulin
28	Rotman et al.	2003	19/F	ACTH secreting	Extrasellar extension	CRH
29	Yoshino et al.	2007	36/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH, insulin
30	Yoshino et al.	2007	38/M	Nonfunctioning	Extrasellar extension	TRH, insulin
31	Wang et al.	2007	41/F	GH secreting	Extrasellar extension	TRH, LH-RH, insulin, L-Dopa
32	Kılıçlı et al.	2010	52/M	Nonfunctioning	Extrasellar extension	TRH, LH-RH, insulin
33	Our cases	2011	56/F	Nonfunctioning	Extrasellar extension	GRF, TRH, LH-RH, CRH
34	Our cases	2011	73/M	Nonfunctioning	Extrasellar extension	GHRP2, TRH, LH-RH, CRH

(b) Reported cases of pituitary apoplexy associated with endocrine stimulation test: treatment and outcomes of the 23 cases, for whom detailed treatments and outcomes were available

Case no.	Treatment	Interval from onset to surgery	Outcomes
1	Medication	—	GH reduction, DI
2	Craniotomy	Undocumented	Panhypopituitarism
3	Craniotomy	Undocumented	Visual disturbance, hemiparesis, aphasia
9	Transsphenoidal surgery	The same day (8.5 hours)	Visual disturbance, hemiparesis, aphasia
11	Craniotomy	3 days later	Recovered completely
13	Transsphenoidal surgery	11 days later	Recovered completely
14	Transsphenoidal surgery	Undocumented	Hypopituitarism
17	Craniotomy	The same day and 17 days after	Recovered completely
18	Medication	—	Hypopituitarism
19	Craniotomy	The same day (7 hours)	Recovered completely
20	Craniotomy	5 days later	Hypopituitarism
22	Transsphenoidal surgery	4 days later	Hypopituitarism
24	Transsphenoidal surgery	2 weeks later	Hypopituitarism
25	Transsphenoidal surgery	9 days later	Hypopituitarism
26	Transsphenoidal surgery	2 days later	Visual disturbance, ophthalmoplegia
27	Transsphenoidal surgery	1 day later (30 hours)	Improved to the level of preoperative state
28	Medication	—	Hypopituitarism
29	Transsphenoidal surgery	The same day and 21 days after	Hypopituitarism
30	Transsphenoidal surgery	7 days later	Hypopituitarism
31	Transsphenoidal surgery	2 days later	Ophthalmoplegia
32	Transsphenoidal surgery	The same day	Recovered completely
33	Transsphenoidal surgery	The same day	Visual disturbance
34	Transsphenoidal surgery	The same day	Recovered completely