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Recurrent cavernous sinus thrombosis: a rare complication of Cushing disease
  1. Chin Voon Tong and
  2. Chee Kit Tee
  1. Department of Medicine, Hospital Melaka, Melaka, Malaysia
  1. Correspondence to Dr Chin Voon Tong; tchinvoon{at}yahoo.com

Abstract

A 14-year-old girl who presented in 2017 with headache, unilateral right eye ptosis and secondary amenorrhoea had an initial workup consistent with non-functioning pituitary macroadenoma. She underwent debulking of pituitary tumour in October 2017. Postoperatively, she developed recurrent cavernous sinus thrombosis. In view of recurrent thrombosis, she was reinvestigated and was found to have adrenocorticotropic hormone-dependent Cushing. Follow-up MRI 1 year after initial presentation showed that there was structural recurrence of pituitary macroadenoma. She subsequently underwent a petrosal craniotomy for debulking of tumour. Postsurgery she remained biochemically Cushingnoid. MRI 5 months after second surgery showed an enlarging pituitary mass which was deemed inoperable. A multidisciplinary meeting discussion consensus for treatment included radiotherapy and somatostatin analogue, pasireotide. She completed 30 cycles of radiotherapy and MRI post radiotherapy showed reduction in the size of the macroadenoma. Currently, she is waiting for pasereotide initiation.

  • paediatrics (drugs and medicines)
  • endocrinology
  • pituitary disorders
  • neurology
  • neuroendocrinology

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Footnotes

  • Contributors CVT authored and reviewed the paper. CKT authored the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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