Pituitary Hyperplasia In A Female Patient With A Severe Childhood Abuse History.
Perozo, Andrea F. Figueiredo, Tiago. Caarls, Michelle B. Segenreich, Daniel. Neto, Leonardo V.
Published: March-April 2018
Journal of Trauma and Dissociation
Vol. 19, No. 2 , p. 136-142
Taylor and Francis Group
530 Walnut Street Suite 850
Philadelphia, PA 19106
A 24-year-old Caucasian female patient was referred to our endocrinology service to investigate a structural magnetic resonance imaging (sMRI) finding of “pituitary mass”. The first two sMRI were identified as pituitary adenoma but the following two examinations suggested the possibility of pituitary hyperplasia (PH). The patient was referred to our service for diagnostic clarification and therapy due to the divergence in sMRI reports and the surgical procedure indicated by the neurosurgical team of the other institution. The patient had no complaints, laboratory tests were all normal, and the sMRI clearly showed a PH. However, what caught our attention was her behavior. During the interview she was intermittently talking and acting like a child even though her age was 24. She reported being a foster child and was severely mistreated during childhood. Parallel psychiatric evaluation was requested and an association between the PH and the childhood abuse was identified. Early life stress may be associated with accelerated pituitary gland volume development, but there is still a paucity of data in literature about this issue. We should be aware of other cases like this one, and a correct differential diagnosis may contribute to contraindicate transsphenoidal surgery. When a childhood abuse history is present, we recommend admission to a psychiatric facility for adequate treatment. (Author abstract)
child abuse; Adults abused as children; childhood trauma; foster children; sequelae; mental disorders; mental health services; child health