A Rare Case of SARS-CoV-2 Infection Associated With Pituitary Apoplexy Without Comorbidities

Abstract

Pituitary apoplexy is a medical and surgical emergency caused by hemorrhage or infarction of the hypophysis, which typically occurs within a pituitary adenoma. It is usually characterized by severe (often thunderclap) headache, visual disturbances, cranial nerve impairments, and hormonal deficiencies. We herein report a case of a previously healthy woman with severe acute respiratory syndrome coronavirus 2 infection associated with pituitary apoplexy. The plausible pathophysiological mechanisms of pituitary apoplexy in infectious coronavirus disease 2019 are discussed.

Keywords: COVID-19; SARS-CoV-2; pituitary apoplexy.

Figure 1.

Contrast-enhanced magnetic resonance imaging of the brain revealing a well-defined “snowman-shaped” large heterogeneous solid-cystic lesion in the suprasellar region (measuring 24 × 25 × 31 mm) with fluid-fluid levels and predominantly cystic component. The cystic component showed various signal intensities both on T1-weighted (A, axial and B, sagittal views) and T2-weighted (C, coronal view) images. Foci of blooming on gradient echo images were observed within the lesion (more on the anterior aspect of the fluid-fluid level) (D, axial view).

Figure 2.

A brief timeline of the clinical course of the patient from symptom onset.