Manic episode revealing a pituitary adenoma: From a clinical case and literature review

Pituitary adenomas are common intracranial tumors, yet psychiatric manifestations as presenting symptoms remain uncommon and often overlooked. We report the case of a 37-year-old man with no prior medical or psychiatric history who initially presented with a rapidly progressive manic episode with psychotic features. Clinical deterioration, including cognitive impairment and confusion, prompted neuroimaging, which revealed a non-secreting pituitary macroadenoma. The patient underwent transsphenoidal surgery, followed by significant improvement in mood stability and cognitive functioning. This case highlights the potential for pituitary adenomas—particularly non-secreting types—to manifest primarily through psychiatric symptoms due to mass effect or secondary hormonal dysfunction. Early recognition of atypical psychiatric presentations is critical to avoid diagnostic delay and ensure appropriate multidisciplinary management. A brief review of the literature is provided to contextualize the association between pituitary tumors and psychiatric manifestations