Hoarding disorder secondary to pituitary adenoma: a case study

Trevizol, Alisson Paulino; Shiozawa, Pedro; Machado, Rodrigo Menezes; Alberto, Rodrigo Lancelote; Ramos, Carlos Fernando; Cordeiro, Quirino

doi:10.1590/0004-282X20160034

Forty-three-year-old female with hoarding disorder for one year. No other neuropsychiatric background was referred. No laboratory changes. MRI showed a solid-cystic expansive tumor of 65 x 47 x 41mm with significant mass effect over adjacent structures. Patient went through neurosurgery but died at the second day of post-operatory. Surgical pathology showed a slow-growth non-secreting pituitary adenoma. Neuroimaging studies of patients with hoarding disorder have drawn attention to specific brain regions related to the symptoms, including anterior cingulate cortex, dorsolateral prefrontal cortex and orbitofrontal cortex¹1. Weitzner MA. Neuropsychiatry and pituitary disease: an overview. Psychother Psychosom. 1998;67(3):125-32. doi:10.1159/000012272
https://doi.org/10.1159/000012272... ^,²2. Mathews CA, Perez VB, Delucchi KL, Mathalon DH. Error-related negativity in individuals with obsessive-compulsive symptoms: toward an understanding of hoarding behaviors. Biol Psychol. 2012;89(2):487-94. doi:10.1016/j.biopsycho.2011.12.018
https://doi.org/10.1016/j.biopsycho.2011... ^,³3. Weitzner MA, Kanfer S, Booth-Jones M. Apathy and pituitary disease: it has nothing to do with depression. J Neuropsychiatry Clin Neurosci. 2005;17(2):159-66.. These structures were compressed by the tumor in the present case and could hypothetically be related to clinical presentation.

Figure
MRI showed a solid-cystic expansive tumor of 65 x 47 x 41 mm with significant mass effect over adjacent structures.

References

¹
Weitzner MA. Neuropsychiatry and pituitary disease: an overview. Psychother Psychosom. 1998;67(3):125-32. doi:10.1159/000012272
» https://doi.org/10.1159/000012272
²
Mathews CA, Perez VB, Delucchi KL, Mathalon DH. Error-related negativity in individuals with obsessive-compulsive symptoms: toward an understanding of hoarding behaviors. Biol Psychol. 2012;89(2):487-94. doi:10.1016/j.biopsycho.2011.12.018
» https://doi.org/10.1016/j.biopsycho.2011.12.018
³
Weitzner MA, Kanfer S, Booth-Jones M. Apathy and pituitary disease: it has nothing to do with depression. J Neuropsychiatry Clin Neurosci. 2005;17(2):159-66.