Pituitary Tumor Hemorrhage in Cushing Disease
Authors: Leilani B. Mercado-Asis
Journal: Annals of Internal Medicine (1995)

Brief Communications1 February 1995Pituitary Tumor Hemorrhage in Cushing DiseaseLeilani B. Mercado-Asis, MD, PhD, Edward H. Oldfield, MD, and Gordon B. Cutler, MDLeilani B. Mercado-Asis, MD, PhDFrom the National Institutes of Health, Bethesda, Maryland., Edward H. Oldfield, MDFrom the National Institutes of Health, Bethesda, Maryland., and Gordon B. Cutler, MDFrom the National Institutes of Health, Bethesda, Maryland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-3-199502010-00006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Spontaneous pituitary hemorrhage and necrosis (pituitary apoplexy) have been reported to occur in 9.5% to 16.6% of pituitary tumors [1-3]. However, pituitary apoplexy rarely develops in patients with Cushing disease. The clinical presentation of pituitary hemorrhage varies from no symptoms to a neurosurgical emergency in which structures in the sellar and parasellar regions are compressed [1-3]. Transient hypopituitarism is common after pituitary apoplexy. Pituitary function may improve either spontaneously [4, 5] or after surgical decompression [6, 7].We describe two patients who developed adrenal insufficiency and subsequently Cushing disease after hemorrhage into adrenocorticotropin hormone (ACTH)-secreting pituitary microadenomas. To our knowledge, ...References1. Mohr G, Hardy J. Hemorrhage, necrosis, and apoplexy in pituitary adenomas. Surg Neurol. 1982; 18:181-9. Google Scholar2. Wakai S, Fukushima T, Teramoto A, Sano K. Pituitary apoplexy: its incidence and clinical significance. J Neurosurg. 1981; 55:187-93. Google Scholar3. Rovit RL, Berry R. Cushing's syndrome and the hypophysis: a re-evaluation of pituitary tumors and hyperadrenalism. J Neurosurg. 1965; 23:270-95. Google Scholar4. Pelkonen R, Kuusisto A, Salmi J, Eistola P, Raitta C, Karonen S, et al. Pituitary function after pituitary apoplexy. Am J Med. 1978; 65:773-8. Google Scholar5. Veldhuis JD, Hammond JM. Endocrine function after spontaneous infarction of the human pituitary: report, review, and reappraisal. Endocr Rev. 1980; 1:100-7. Google Scholar6. Arafah BM, Harrington JF, Madhoun ZT, Selman WR. Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy. J Clin Endocrinol Metab. 1990; 71:323-8. Google Scholar7. Onesti ST, Wisniewski T, Post KD. Clinical versus subclinical pituitary apoplexy: presentation, surgical management, and outcome in 21 patients. Neurosurgery. 1990; 26:980-6. Google Scholar8. Cardoso ER, Peterson EW. Pituitary apoplexy: a review. Neurosurgery. 1984; 14:363-73. Google Scholar9. Reid RL, Quigley ME, Yen SS. Pituitary apoplexy. A review. Arch Neurol. 1985; 42:712-9. Google Scholar10. Rovit RL, Fein JM. Pituitary apoplexy: a review and reappraisal. J Neurosurg. 1972; 37:280-8. Google Scholar11. Ahmed M, Rifai A, Al-Jurf M, Akhtar M, Woodhouse N. Classical pituitary apoplexy presentation and a follow-up of 13 patients. Horm Res. 1989; 31:125-32. Google Scholar12. Schulte HM, Chrousos GP, Oldfield EH, Gold PW, Cutler GB Jr, Loriaux DL. Ovine corticotropin-releasing factor administration in normal men. Pituitary and adrenal responses in the morning and evening. Horm Res. 1985; 21:69-74. Google Scholar Author, Article, and Disclosure InformationAuthors: Leilani B. Mercado-Asis, MD, PhD; Edward H. Oldfield, MD; Gordon B. Cutler, MDAffiliations: From the National Institutes of Health, Bethesda, Maryland.Corresponding Author: Leilani B. Mercado-Asis, MD, PhD, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, 10N262, Bethesda, MD 20892. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySpontaneous remission of Cushing's disease: A systematic reviewSpontaneous remission of hypercortisolism presumed due to asymptomatic tumor apoplexy in ACTH-producing pituitary macroadenomaACTH-producing remnants following apoplexy of an ACTH-secreting pituitary macroadenomaPituitary tumor apoplexy in patients with Cushing's disease: endocrinologic and visual outcomes after transsphenoidal surgeryApoplexy in a corticotrophin-secreting pituitary macroadenoma: a case report and review of the literatureRepeated Remissions of Cushing's Disease Due to Recurrent Infarctions of an ACTH-Producing Pituitary MacroadenomaPituitary apoplexy induced by corticotrophin-releasing hormone in a patient with Cushing's diseaseResolution of Cushing's Disease Followed by Secondary Adrenal Insufficiency After Anticoagulant-Associated Pituitary Hemorrhage: Report of a Case and Review of the LiteratureA Case of Cushing's Disease Revealed Six Years after Postpartum HypopituitarismApoplexia pituitária seguida de remissão endócrina: relato de dois casos 1 February 1995Volume 122, Issue 3Page: 189-190KeywordsAdrenocorticotropic hormoneBlood plasmaCortisolHemorrhageNecrosisPituitary glandPituitary tumorsPregnancyStrokeThyroid ePublished: 15 August 2000 Issue Published: 1 February 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. 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