35
Headache Medicine, v.10, n.1, p.35, 2019
CASE REPORT
Coexistence of Sunct Syndrome and pituitary tumor: A
possible association to be recognized
Coexistência entre Cefaleia do tipo SUNCT e tumor pituitário:
Uma associação que deve ser reconhecida
Julia Vescovi Vieira
1
Amanda dos Santos Cintra
1
Ana Paula Alves Fonseca
2
Antônio José da Rocha
2
Renan Barros Domingues
1
1
Department of Neurology, Irmandade Santa
Casa de Misericórdia de São Paulo, São Paulo,
Brazil.
2
Department of Neuroradiology, Irmandade
Santa Casa de Misericórdia de São Paulo, São
Paulo, Brazil.
*Correspondence
Julia Vescovi Vieira
E-mail: jvescovivieira@gmail.com
Received: January 31, 2019.
Accepted: February 15, 2019.
A 46-year-old woman reported headache with migraine without
aura and SUNCT symptoms. A previous diagnosis of pituitary
macroadenoma was confirmed with MR and an increased prolactin.
Cabergoline was started with improvement of symptoms. An imaging
follow-up showed a reduction of the macroadenoma (Figure 1).
Pituitary adenoma is a intracranial tumor that has been reported
in about 8% of patients with SUNCT. Dural stretch and hormonal
dysfunction are possible mechanisms for this association. The fact
that tumor and SUNCT were ipsilateral and that headache improved
after cabergoline may suggest an association between these
entities, supporting MR investigation when this type of headache is
diagnosed.
REFERENCES
1. Levy M, Matharu M, Meeran K, Powell M. The clinical characteristics of
headache in patients with pituitary tumours. Brain. 2005;128(8):1921–30.
2. Chitsantikul P, Becker WJ. SUNCT, SUNA and pituitary tumors: Clinical
characteristics and treatment. Cephalalgia. 2013;33(3):160–70.
3. Pareja J, Caminero A, Sjaastad O. SUNCT syndrome: diagnosis and
treatment. Headache. 2003;43(306).
Figure 1. Pituitary MRI, coronal post-gadolinium T1-weighted sequence (a)
demonstrate a rounded region of delayed enhancement in the left pituitary compared
to the rest of the gland, compatible with adenoma. (b) Imaging follow-up showed a
signicant reduction of the lesion.
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