Necrotic Apoplexy of Pituitary Adenoma; A Report of Three Cases

Apoplexy is relatively a rare clinical expression or revelation of pituitary adenoma. Necrotic apoplexy is a subgroup with unique findings in its different aspects. Early surgical resection through the transsphenoidal route is the main modality for their management. We report three cases of patients with necrotic apoplexy. we reviewed the circumstances of revelation, the imaging features, surgical findings, and the results of histological analysis. The age of patients ranged between 22 and 53 years old. All patients complained of headaches and visual disorders. At the MRI evaluation, they had the same radiological features of necrotic apoplexy. They received endoscopic endonasal surgery for the resection and the histological analysis confirmed the presence of necrosis areas in the sampled tissues. Necrotic apoplexy is a rare and unique clinical entity. At the imaging, it appears as a solid sellar mass, iso to hyperintense in both sequences T1 and T2. during the surgical removal, the lesion is yellowish and poorly bleeding without hemorrhagic contents. The histological studies reveal large areas of necrosis in similar lesions.