Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tz-You 1st Road, Kaohsiung, Taiwan.
World J Surg Oncol. 2013 Oct 2;11:254. doi: 10.1186/1477-7819-11-254.
We present the first Asian case of a 77-year-old man who developed pituitary apoplexy (PA) soon after gonadotropin-releasing hormone agonist (GnRHa) (leuprorelin) injection to treat prostate cancer. Headache, ophthalmoplegia, visual field deficit, nausea, and vomiting are the typical characteristics of pituitary apoplexy. Though the occurrence rate is rare, the consequence of this condition can vary from mild symptoms such as headache to life-threatening scenarios like conscious change. Magnetic resonance imaging is the best imaging modality to detect PA and sublabial trans-sphenoid pituitary tumor removal can resolve most of PA symptoms and is so far the best solution in consensus. We also review 11 previous reported cases receiving GnRHa for androgen deprivation therapy of prostate cancer, and hope to alert clinicians to use GnRHa with caution.
我们报告了首例亚洲 77 岁男性病例,该患者在注射促性腺激素释放激素激动剂(GnRHa)(亮丙瑞林)治疗前列腺癌后不久发生垂体卒中(PA)。头痛、眼肌麻痹、视野缺损、恶心和呕吐是垂体卒中的典型特征。尽管这种情况的发生率较低,但这种情况的后果可能从头痛等轻微症状到意识改变等危及生命的情况不等。磁共振成像(MRI)是检测垂体卒中的最佳影像学方法,经唇下经蝶窦垂体瘤切除术可以解决大多数垂体卒中症状,目前是共识中的最佳解决方案。我们还回顾了 11 例先前报道的接受 GnRHa 进行前列腺癌去势治疗的病例,希望提醒临床医生谨慎使用 GnRHa。