From: Apoplexy of Crooke cell tumour leading to the diagnosis of severe Cushing disease; a case report
Month/year | Events | Diagnostic tests | Interventions |
---|---|---|---|
2009 | Secondary amenorrhoea | None | None |
From beginning of 2019 | weight gain, darkening of skin, multiple acne and difficulty in getting up from squatting position | None | None |
August/2019 | Sudden onset headache and blindness | Visual assessment: complete blindness of left eye and finger counting from right eye with temporal visual loss MRI-pituitary: giant pituitary tumour with bleeding Biochemistry: hypokalaemia, elevated cortisol, central hypothyroidism, low FSH, LH | Trans-sphenoidal excision of the pituitary tumour Histology: Crooke cell tumour Started levothyroxine and hydrocortisone replacement |
November/2019 | Follow up | MRI-pituitary: No residual tumour Visual field: bitemporal hemianopia (improved) Twenty four hour urinary cortisol: normal 9 am cortisol: 181 nmol/L | Started cyclical oestrogen and progesterone, levothyroxine continued |
September/2020 | Follow up | MRI-pituitary: No residual tumour Twenty four hour urinary cortisol: normal | Continued same treatment |