Pituitary apoplexy in endocrinologically silent adenoma during somatostatin analog administration for pancreatic neuroendocrine tumor: A case report

A dopamine agonist administered for prolactinoma treatment and pituitary stimulation tests are reported as risk factors for pituitary apoplexy. We report a case of an 82-year-old patient who suffered from pituitary apoplexy in an endocrinologically silent adenoma during lanreotide administration. The patient was diagnosed with a pancreatic neuroendocrine tumor with lymph node metastasis and treated with lanreotide for two years. An endoscopic endonasal transsphenoidal approach was used for tumor and hematoma removal. The specimen showed growth hormone and prolactin positivity and was diagnosed as pit1-lineage plurihormonal adenoma. The tumor also showed positivity for somatostatin receptor 2. Thus, lanreotide treatment is a risk factor for pituitary apoplexy even in silent adenoma.

Automated summary

This case report highlights the risk of pituitary apoplexy in an endocrinologically silent adenoma during lanreotide administration. The patient, previously diagnosed with a pancreatic neuroendocrine tumor, developed pituitary apoplexy after two years of lanreotide treatment. The tumor was confirmed as a pit1-lineage plurihormonal adenoma and expressed somatostatin receptor 2. These findings suggest that lanreotide treatment increases the risk of pituitary apoplexy, even in asymptomatic adenomas.