{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:04Z","timestamp":1756278604152,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,30]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2021-243786","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T12:05:33Z","timestamp":1624363533000},"page":"e243786","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent cavernous sinus thrombosis: a rare complication of Cushing disease"],"prefix":"10.1136","volume":"14","author":[{"given":"Chin Voon","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Medicine, Hospital Melaka, Melaka, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chee Kit","family":"Tee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Melaka, Melaka, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"2025082623503142000_14.6.e243786.1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1227\/01.NEU.0000166580.94215.53","article-title":"Cushing's disease in children and adolescents: 20 years of experience in a single neurosurgical center","volume":"57","author":"Joshi","year":"2005","journal-title":"Neurosurgery"},{"key":"2025082623503142000_14.6.e243786.2","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1001\/archsurg.136.9.1003","article-title":"Biochemical basis for the hypercoagulable state seen in Cushing syndrome; discussion 1006-7","volume":"136","author":"Jacoby","year":"2001","journal-title":"Arch Surg"},{"key":"2025082623503142000_14.6.e243786.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1983.tb00025.x"},{"key":"2025082623503142000_14.6.e243786.4","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1136\/jnnp.2004.057315","article-title":"Cerebral sinus thrombosis in a patient with Cushing\u2019s syndrome Journal of Neurology","volume":"76","author":"Yoshimura","year":"2005","journal-title":"Neurosurgery & Psychiatry"},{"key":"2025082623503142000_14.6.e243786.5","unstructured":"Plewa MC , Tadi P , Gupta M . Cavernous Sinus Thrombosis. In: StatPearls. Treasure Island, FL: StatPearls Publishing, 2021. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448177\/"},{"key":"2025082623503142000_14.6.e243786.6","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s12020-019-02036-2","article-title":"Treatment challenges in pediatric Cushing's disease: review of the literature with particular emphasis on predictive factors for the disease recurrence","volume":"66","author":"Pasternak-Pietrzak","year":"2019","journal-title":"Endocrine"},{"key":"2025082623503142000_14.6.e243786.7","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-06-0588"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:50:39Z","timestamp":1756277439000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,22]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2021-243786"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243786","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}