Invasive pituitary carcinoma associated with antiphospholipid syndrome: a rare case revealed by postpartum cerebral venous thrombosis (case report).

Source: PubMed, NCBI / U.S. National Library of Medicine

Pituitary carcinoma is an exceptionally rare and aggressive tumor, often diagnosed late due to nonspecific symptoms. Its presentation as postpartum cerebral venous thrombosis is extremely uncommon, and the coexistence of antiphospholipid syndrome further complicates diagnosis and management. We report the case of a 30-year-old woman with a history of recurrent miscarriages who presented 45 days postpartum with severe intracranial hypertension syndrome. Brain magnetic resonance imaging (MRI) with venous MR angiography demonstrated thrombosis of the right lateral sinus extending into the internal jugular vein, along with an invasive intra-sellar mass compressing the optic chiasm and filling the sphenoid sinus. Endoscopic endonasal transsphenoidal surgery allowed partial tumor resection with optic pathway decompression, and histopathology confirmed pituitary carcinoma. The etiologic workup identified positive antiphospholipid antibodies. Management included full-dose anticoagulation and close neurological, endocrinological, and hematological monitoring. This report illustrates a rare and diagnostically challenging coexistence of antiphospholipid syndrome and invasive pituitary carcinoma. It highlights the diagnostic complexity and the need for rapid, multidisciplinary management in atypical presentations.