The Patient with Pituitary Disease

  • Irene Osborn


A 41-year-old woman with the diagnosis of a suprasellar lesion was admitted for transsphenoidal hypophysectomy. The patient reported a 1–2 year history of headaches, with decreasing vision in the left eye. She also noted postmenopausal bleeding for 3 years. She denied other neurologic or physical problems at the time of admission.

She had previously had a pilonidal cyst excision under general anesthesia without problems. Medical history was negative for hypertension, diabetes mellitus, cardiac symptoms, respiratory disease, or allergies, and the patient was not taking any medications. She smoked one pack of cigarettes a day but denied alcohol or drug use.

Physical examination revealed an obese woman (245 lb), who was alert, oriented, and cooperative. Vital signs were within normal limits. Head and neck examination revealed 4 missing upper teeth, but no other abnormalities were found. Chest examination was negative with lungs clear, and no cardiac murmurs. On neurological examination, the patient demonstrated intact cranial nerves but had a deficit in the left lateral visual field. No abnormalities were found on motor and sensory examinations.

Laboratory data included: hematocrit 32.4%, hemoglobin 10.7 gm, potassium 5.0 mEq/l, sodium 140 mEq/l. Endocrine evaluation was negative except for a serum prolactin level of 59 nglml (normal level, 5–10 ng/ml). Computed tomography scan showed a suprasellar lesion with extension into the left parasellar region. Angiography revealed a nonvascular pituitary lesion extending above the sella turcia. The patient was scheduled for transsphenoidal surgery.


Growth Hormone Pituitary Adenoma Transsphenoidal Surgery Posterior Pituitary Serum Prolactin Level 
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© Birkhäuser Boston Inc. 1989

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  • Irene Osborn

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