Nonsurgical Management of a Patient with Hypopituitarism Secondary to Nonfunctioning Pituitary Macroadenoma: A Case Report

Abstract

Pituitary adenoma is a benign neoplasm of pituitary gland. Pituitary adenoma, particularly a macroadenoma,
may produce mass effect symptoms by compressing surrounding tissues. Due to pituitary function as a
neuroendocrine organ, pituitary adenoma may also cause multiple endocrine disturbances. The authors report
the case of a 39-year-old male patient presenting with chronic headache and history of seizure. MRI imaging
revealed pituitary macroadenoma with optic chiasm compression. Further diagnostic workup indicated
secondary hypogonadism and adrenal insufficiency. The patient was given hormone replacement therapy
and was then advised for surgery, but the patient refused any surgical procedure. Subsequent follow-ups
were somewhat difficult due to poor patient adherence. Nevertheless, appropriate management of pituitary
adenoma is needed to achieve optimal result.