Conservative management of pituitary tumor apoplexy

SUMMARY Pituitary tumor apoplexy is a rare neuroendocrine syndrome resulting, in most cases, from hemorrhage or infarctation of a pre-existing pituitary adenoma. Treatment recommendations vary; some authors advocate urgent surgical decompression of the tumor, whereas others su-ggest that conservative management can lead to recovery of neuro-ophthalmologic function. We describe two patients with pituitary tumor apoplexy who had clinically non-functioning ma-croadenomas and hypopituitarism, including hypogonadism. They were treated conservatively without surgery, and achieved tumor remission. Arq Bras Endocrinol Metab. 2011;55(5):345-8 SUMaRio A apoplexia pituitaria e uma rara sindrome neuroendocrina causada, na maioria dos casos, pela hemorragia ou enfarte de um adenoma pituitario preexistente. O tratamento recomen-dado e variavel; alguns autores defendem a descompressao cirurgica do tumor em regime de urgencia, enquanto outros sugerem que o tratamento conservador pode levar a recuperacao da funcao neuroftalmologica. Descrevemos os casos de dois pacientes com apoplexia pituitaria que apresentaram macroadenomas clinicamente nao secretores e hipopituitarismo, incluindo hipogonadismo. Ambos foram submetidos ao tratamento conservador, sem cirurgia, e houve a remissao do tumor.