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Case Reports
. 2021 Feb 12;13(2):e13315.
doi: 10.7759/cureus.13315.

Pituitary Apoplexy Attributed to COVID-19 Infection in the Absence of an Underlying Macroadenoma or Other Identifiable Cause

Stephen J Bordes  1 , Simone Phang-Lyn  2 , Edinson Najera  3 , Hamid Borghei-Razavi  4 , Badih Adada  3
Affiliations
Case Reports

Pituitary Apoplexy Attributed to COVID-19 Infection in the Absence of an Underlying Macroadenoma or Other Identifiable Cause

Stephen J Bordes et al. Cureus. .

Abstract

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is responsible for an array of extrapulmonary manifestations, including direct and indirect neurological complications. Currently, all published cases noting pituitary apoplexy in patients with COVID-19 have discovered underlying pituitary macroadenomas. Herein, we describe the first documented case, to our knowledge, of pituitary apoplexy attributed solely to COVID-19 in the absence of other identifiable causes. While much remains to be discovered and understood regarding COVID-19, we discuss the potential pathophysiology of COVID-19-associated pituitary apoplexy and raise awareness of this clinical complication.

Keywords: covid-19; neurosurgery; pituitary apoplexy; sars-cov-2.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial unenhanced CT scan of the brain demonstrates an 8 mm sellar/suprasellar high-density lesion with mass effect on the optic chiasm (arrow)
CT, computed tomography
Figure 2
Figure 2. Initial MRI results
Sagittal T1-weighted MRI (A) and axial T2-weighted MRI (B) images of the brain show high signal intensity suggestive of recent hemorrhage. Coronal gadolinium-enhanced T1-weighted MRI (C) revealing a 14 mm heterogeneously enhancing sellar lesion with suprasellar extension and effacing the optic chiasm. T1, longitudinal relaxation time; T2, transverse relaxation time; MRI, magnetic resonance imaging
Figure 3
Figure 3. Follow-up MRI results
Coronal T2-weighted MRI (A), coronal gadolinium-enhanced T1-weighted MRI (B), and sagittal gadolinium-enhanced T1-weighted MRI (C) demonstrate interval evolution of an intrapituitary hemorrhage, which drastically decreased in size, and show both subacute and chronic blood products with a new size of 8 mm x 4 mm. The pituitary gland is normal in size without extension to the suprasellar cistern or mass effect on the optic chiasm. T1, longitudinal relaxation time; T2, transverse relaxation time; MRI, magnetic resonance imaging
See this image and copyright information in PMC

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