Pituitary Apoplexy Revealing A Pediatric Prolactinoma: A Case Report

Pituitary apoplexy (PA) is an extremely uncommon condition in children and adolescents. It’s an acute state involving hemorrhage or infarction of the pituitary gland. This article presents a case report of an 11-year-old pubertal female who presented intense cranial headaches with a sudden deterioration in her visual acuity especially in her right eye. Laboratory testing revealed very high prolactin levels exceeding 2000 ng/ml. Pituitary MRI (Magnetic Resonance Imaging) showed an intra-sellar pituitary lesion described as hyperintense on T1 and T2 and characteristics of hemorrhage consistent with a pituitary macroadenoma in apoplexy. The patient underwent endoscopic endonasal transsphenoidal surgery of the tumor. Postoperative evolution was marked by amelioration of right eye vision and a decreased level of prolactin. The biological profile was marked by persistence of panhypopituitarism, hormonal replacement therapy was prescribed. As far as we are aware, since 1980, only 30 cases of clinical pituitary apoplexy have been reported in patients under 20 years of age. The present case is the 31st and involves the youngest patient reported to date. This case highlights the importance of early recognition, prompt surgical intervention, and the critical role of multidisciplinary care in managing pediatric pituitary disorders.