The Timing of Surgery and Salvable Vision in Pituitary Adenoma

Two cases of pituitary macroadenomas are the basis for this study. The first; a 70 year old female who had a nonfunctioning pituitary macroadenoma presented with headache and visual impairment. Surgery was indicated but she declined until two years later when visual acuity got worse. The second was a 25 year old male who presented with a prolactinoma and diabetes. Visual abnormalities were related only to the left eye. When it was suggested that surgery might be indicated; he never kept the next appointment. Delay in effecting appropriate surgery timely is known to upset desired results. What is particular in this case is the attendant loss of vision; a very serious disability which could have been prevented. Those prone to fear of surgery should be assisted to understand their situations better and efforts made to encourage them to take the correct decision

Cas clinique : adenome hypophysaire hypersecretant la prolactine

Le prolactinome; tumeur hypophysaire se manifestant par des troubles hormonaux est rare au Zaire. Sa frequence chez le Noir Africain n'est pas connue. Les auteurs rapportent le cas d'un gros prolactinome en trente six mois de pratique de Scanner chez un malade de 30 ans qui consulta pour des signes non-hormonaux: cephalee; diplopie

Rappel theorique : Investigation biologique et radiologique du prolactinome

Les methodes permettant le diagnostic du prolactinome ont fortement evalue ces deux dernieres decennies grace aux progres realises en imagerie medicale et en radio-immunologie. Des qu'une elevation du taux de prolactine est demontree a la suite d'une symptomatologie suspecte; le diagnostic d'un adenome hypophysaire hyper-secretant de la prolactine est loin d'etre certain. Les causes pouvant etre responsables de cette elevation sont discutees