Nielsen EH et al. (2006) Frequent occurrence of pituitary apoplexy in patients with non-functioning pituitary adenoma. Clin Endocrinol 64: 319–322

The literature states that PITUITARY APOPLEXY is a rare disorder; however, a new study by Nielsen and colleagues suggests that the disorder occurs more frequently than previous reports indicate.

In this retrospective, Danish study, the authors identified 192 patients with suprasellar, clinically inactive adenoma who were operated on between 1985 and 1996. The median follow-up period after surgery was 13.7 years. Pituitary apoplexy was diagnosed in 41 (21%) patients. After surgery, 9 of these patients had normal pituitary function, 14 were panhypopituitary, 14 had partial pituitary insufficiency, and 4 patients were not assessed. Overall, 12 patients with pituitary apoplexy died during the follow-up period, giving a standard mortality ratio of 1.09 (95% CI 0.62–1.92), which was similar to the standard mortality ratio for the remaining 151 patients who did not have pituitary apoplexy (1.17; 95% CI 0.86–1.59).

Despite the use of strict criteria to diagnose patients with pituitary apoplexy, the authors conclude that the incidence of this disorder is much higher than was observed in previous studies, which found an incidence of between 1.9% and 6.8%. The authors highlight their finding that the survival outcome of all patients with a nonfunctioning adenoma who undergo surgery is independent of the occurrence of pituitary apoplexy.