Carl Gandola, MD
To the Editors: Molitch and Russell (1) and Reincke and coleagues l(2) recently reviewed the management of patients with asymptomatic pituitary adenomas, "incidentalomas" (10% to 20% of the population). Neither review, however, mentions the potential risks of cardiac surgery for these patients.
Several cases have been reported in which cardiac surgery precipitated pituitary hemorrhage in patients with pituitary adenomas (3-5). Cooper and colleagues (3) speculated that cardiopulmonary bypass may be a specific risk on the basis of changes in perfusion pressure, oncotic pressure, and hemodilution leading to edema, ischemia, and hemorrhage. As more patients with pituitary incidentalomas are followed, the
Gandola C. Asymptomatic Pituitary Adenomas. Ann Intern Med. ;113:482. doi: 10.7326/0003-4819-113-6-482_1
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Published: Ann Intern Med. 1990;113(6):482.
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