Pituitary tumor and myalgia
Robert S. Kunkel, M.D.
Department of Internal Medicine
A. V. Black, M.D.
Generalized myalgia with painful, tender muscles as a major presenting complaint usually reflects an acute infectious process, most often viral in etiology and requires no extensive diagnostic studies. Symptoms usually abate rapidly and prompt recovery is the rule. Polymyositis, another cause of muscle pain, usually is readily diagnosed because of the symptoms, elevated acute phase reactants in the blood, and abnormal muscle biopsy.
Within a period of a few months we examined two patients with muscle pain and aching, fatigue and weakness who were found to have pituitary tumors with multiple endocrine deficiencies. Our purpose in reporting these cases is to point out that endocrine dysfunction can be the cause of profound muscle symptoms and also to suggest that pituitary lesions should be considered when anyone has muscle complaints secondary to endocrine dysfunction.
Case 1. A 46-year-old man became ill about June 1, 1972. He began to notice pain in his calves when walking. Shortly thereafter he experienced aching discomfort in his back and shoulder muscles. He also noted weakness of his shoulders and thighs. He became anorectic and the weakness progressed. He also had occasional, intermittent dull aching pain on the left side of his head. Initial studies revealed a mild decrease in hemoglobin value and an enlarged sella on roentgenographic examination. Visual fields were normal. He was referred to the Cleveland Clinic for further evaluation. He had had a successful mammary artery implant for coronary artery disease in February 1968. Prior to the current illness he. . .