Spontaneous remission of Cushing’s disease after pituitary apoplexy: a case report and literature review

Pituitary apoplexy can be caused by sudden enlargement of a pituitary tumor due to hemorrhage. Spontaneous resolution of Cushing’s disease from hemorrhage within a pituitary adenoma is rare but possible. We presented a case study of a 17-year-old female patient diagnosed with Cushing’s disease. A microadenoma was observed on sellar imaging at the time of diagnosis. After a severe headache, both the serum and urinary cortisol levels normalized, with imaging at that time raising suspicion of a pituitary tumor with hemorrhage, which was considered as pituitary apoplexy. Ten years later, the patient continued to show no clinical or biochemical signs of hypercortisolism. Spontaneous remission in patients with Cushing’s disease is rare, and pituitary apoplexy seems to be a reasonable explanation. Cases of spontaneous remission of Cushing’s disease after pituitary apoplexy can help establish precise surgical or radiotherapeutic models for the disease. Patients should still undergo careful monitoring, as the long-term outcome and risk of recurrence are uncertain.