PT  - JOURNAL ARTICLE
AU  - Ghada Elshimy
AU  - Rishi Raj
AU  - Aasems Jacob
AU  - Ricardo Correa
TI  - Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment
AID  - 10.1136/bcr-2021-248523
DP  - 2022 Mar 01
TA  - BMJ Case Reports
PG  - e248523
VI  - 15
IP  - 3
4099  - http://casereports.bmj.com/content/15/3/e248523.short
4100  - http://casereports.bmj.com/content/15/3/e248523.full
SO  - BMJ Case Reports2022 Mar 01; 15
AB  - Pituitary apoplexy (PA) is a clinical condition characterised by a sudden increase in pituitary gland volume secondary to ischaemia and/or necrosis. Most cases occur in non-functioning pituitary adenoma but can also occur in functioning adenoma. Certain predisposing factors can result in PA and the use of gonadotropin-releasing hormone (GnRH) agonists for prostate cancer (PCa) is one such condition. Once diagnosed, both surgical and conservative management has been used for the treatment of PA. We present a case of a man in his late 50s who developed PA following treatment of PCa with leuprolide. His symptoms developed insidiously and he presented 6 months after symptom onset. Anterior pituitary hormone workup along with pituitary MRI confirmed the diagnosis of PA and patient was subsequently treated with adequate replacement of pituitary hormone with significant improvement in his symptoms. It is very important to keep a high index of suspicion for PA, especially among elderly patients receiving GnRH agonist treatment for PCa.