Stubborn hiccups as a sign of massive apoplexy in a naive acromegaly patient with pituitary macroadenoma

oleh: Gulay Simsek Bagir, Soner Civi, Ozgur Kardes, Fazilet Kayaselcuk, Melek Eda Ertorer

Format: Article
Diterbitkan: Bioscientifica 2017-05-01

Deskripsi

Pituitary apoplexy (PA) may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI) demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH) levels exhibited suppression (below <1 ng/mL) at all time points during GH suppression test with 75 g oral glucose. After treatment with corticosteroid agents, he underwent transsphenoidal pituitary surgery and hiccups disappeared postoperatively. The GH secretion potential of the tumor was clearly demonstrated immunohistochemically. We conclude that stubborn hiccups in a patient with a pituitary macroadenoma may be a sign of massive apoplexy that may result in hormonal remission.