SIMPLE TEST CAN BE LIFESAVING: PITUITARY ADENOMA: A CASE REPORT

*Chinawa N. E., Odogu V. and Udoh M. M.

ABSTRACT

Aim: Pituitary adenoma is benign tumour of pituitary gland. It can present either as a mass effect or secretory anomalies. The mass effect could cause visual field anomaly (Bitemporal hemianopia), diplopia following compression of constituent cranial nerves in the cavernous sinus which is its very important lateral relation. Secretory anomalies on the other hand could lead to infertility as in prolactinoma, Acromegaly as in growth hormone over secretion and so on. Case Report: SK was a 42 year old female who presented with diplopia, obscuration of left half of objects and a history of galactorrheoa. She had been on management for Glaucoma for two years. However perimetry done revealed bitemporal hemianopia with superior quadrantanopia while a follow up CT scan showed a sellar mass. She had neurosurgical intervention with improvement of visual field and other symptoms. Discussion: The patient was a 42 year old female which is the age and gender at risk for pituitary adenoma. Her history of galactorrheoa and diplopia which are unusual in glaucoma for which she had been on treatment for the previous 2 years arose a high index of suspicion towards a sellar lesion. The finding on perimetry and follow up findings on CT scan changed the entire course of management. To achieve good visual outcome and reduce risk of interference of the gland, she had neurosurgical intervention (Trans nasal excision of pituitary mass) which gave her good visual outcome. Conclusion: Although Glaucoma could present with bumping on objects placed on patients’ side. Effort should be made to characterize this as care-giver may be dealing with bitempoaral hemianopia especially in at risk age group.

Keywords: Bitemporal hemianopia, prolactinoma, galactorrheoa.