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Case Reports
. 2023 Nov 22;23(1):479.
doi: 10.1186/s12886-023-03224-5.

A case report of pituitary neuroendocrine tumor manifesting as severe conjunctival chemosis

Shun Yamamuro  1 , Atsuo Yoshino  2 , Takuma Nishide  2 , Hiroshi Negishi  2 , Takahiro Kumagawa  2
Affiliations
Case Reports

A case report of pituitary neuroendocrine tumor manifesting as severe conjunctival chemosis

Shun Yamamuro et al. BMC Ophthalmol. .

Abstract

Background: Conjunctival chemosis (CC) is an extremely rare symptom of pituitary neuroendocrine tumor (PitNET). We report an extremely rare case of PitNET manifesting as severe CC.

Case presentation: A 48-year-old male was admitted to our hospital with severe CC, proptosis, and ptosis of the right eye. Magnetic resonance imaging demonstrated the tumor mass invading the cavernous sinus (CS) with cystic lesion. The patient underwent emergent endoscopic transsphenoidal surgery, and the pathological diagnosis was PitNET. CC of the right eye remarkably improved after the surgery. Glucocorticoid therapy was performed for right oculomotor nerve palsy, which rapidly improved. The postoperative course was uneventful and the patient was discharged from our hospital without hormone replacement.

Conclusions: CC caused by CS invasion of PitNET can be cured by early surgical treatment. Therefore, PitNET is important to consider in the differential diagnosis of CC.

Keywords: Cavernous sinus; Conjunctival chemosis; Oculomotor nerve palsy; Pituitary neuroendocrine tumor; Transsphenoidal surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a, b Preoperative photographs of the patient’s face demonstrating marked right eye conjunctival chemosis (a: opening by self, b: opening manually). c–f Findings of initial magnetic resonance images (c: coronal T1-weighted imaging, d: coronal T2-weighted imaging, e: coronal gadolinium-enhanced T1-weighted imaging, f: sagittal gadolinium-enhanced T1-weighted imaging). g Findings of initial coronal computed tomography scan. h Findings of initial axial T2-weighted magnetic resonance image focusing around the orbits
Fig. 2
Fig. 2
a, b Postoperative photographs of the patient’s face (a: opening by self, b: opening manually). c, d Photographs of the patient’s face after glucocorticoid treatment (c: eight gaze, d: left gaze). e, f Findings of magnetic resonance images immediately after the surgery (e: coronal gadolinium-enhanced T1-weighted imaging, f: sagittal gadolinium-enhanced T1-weighted imaging). g, h Findings of magnetic resonance images 3 months after the surgery (g: coronal gadolinium-enhanced T1-weighted imaging, h: sagittal gadolinium-enhanced T1-weighted imaging). i Findings of axial T2-weighted magnetic resonance image 3 months after the surgery focusing around the orbits
See this image and copyright information in PMC

References

    1. Budohoski KP, Khawari S, Cavalli A, Quah BL, Kolias A, Waqar M, et al. Long-term oncological outcomes after haemorrhagic apoplexy in pituitary adenoma managed operatively and non-operatively. Acta Neurochir (Wien) 2022;164:1115–1123. doi: 10.1007/s00701-022-05119-8. - DOI - PubMed
    1. Bujawansa S, Thondam SK, Steele C, Cuthbertson DJ, Gilkes CE, Noonan C, et al. Presentation, management and outcomes in acute pituitary apoplexy: a large single-centre experience from the United Kingdom. Clin Endocrinol (Oxf) 2014;80:419–424. doi: 10.1111/cen.12307. - DOI - PubMed
    1. Hage R, Eshraghi SR, Oyesiku NM, Ioachimescu AG, Newman NJ, Biousse V, et al. Third, fourth, and sixth cranial nerve palsies in pituitary apoplexy. World Neurosurg. 2016;94:447–452. doi: 10.1016/j.wneu.2016.07.026. - DOI - PMC - PubMed
    1. Rutkowski MJ, Kunwar S, Blevins L, Aghi MK. Surgical intervention for pituitary apoplexy: an analysis of functional outcomes. J Neurosurg. 2018;129:417–424. doi: 10.3171/2017.2.JNS1784. - DOI - PubMed
    1. Singh TD, Valizadeh N, Meyer FB, Atkinson JLD, Erickson D, Rabinstein AA. Management and outcomes of pituitary apoplexy. J Neurosurg. 2015;122:1450–1457. doi: 10.3171/2014.10.JNS141204. - DOI - PubMed

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