%0 Journal Article
%T Visual vignette- NelsonĄ¯s syndrome: a giant pituitary
%A Ari George Chacko
%A B. Rajesh
%A Deepak Abraham
%A Mahesh Doddabelavangala Mruthyunjaya
%A Nihal Thomas
%A Riddhi Das Gupta
%A Senthil Kumar
%A Sunithi Mani
%J Sri Lanka Journal of Diabetes Endocrinology and Metabolism
%D 2019
%R 10.4038/sjdem.v9i1.7375
%X NelsonĄ¯s syndrome is an infrequent pituitary mass with an incidence of 8¨C43% in adults and 25¨C66% in children that develops following total bilateral adrenalectomy (TBA) for the treatment of CushingĄ¯s disease. It is one of the most challenging of all endocrine conditions. The frequent aggressiveness of the underlying ACTH-secreting pituitary adenoma (corticotrophinoma) necessitates regular biochemical and radiological screening. Current evidence favours a lack of prophylactic neoadjuvant pituitary radiotherapy at the time of TBA and a rapid rise of ACTH levels in the year post TBA as factors that may predict the occurrence of NelsonĄ¯s syndrome. Though, computerized tomography (CT)/magnetic resonance imaging (MRI) have led to the early diagnosis and improvement in management. NelsonĄ¯s related tumours are sometimes detected late, through clinical manifestations of invasion and compression of the surrounding structures. With this perspective in mind, we describe a 22 year old gentleman 10 years after TBA who presented with right sided hemiparesis due to a corticotroph adenoma
%U https://sjdem.sljol.info/articles/10.4038/sjdem.v9i1.7375/