ABSTRACT Introduction Pituitary apoplexy represents an uncommon endocrine emergency with potentially life‐threatening consequences. Gonadotropin‐releasing hormone agonist used for prostate cancer has the potential to induce pituitary apoplexy, particularly in the setting of a preexisting pituitary adenoma. Case Presentation A 76‐year‐old male with prostate cancer initially chose active surveillance; however, prostate‐specific antigen (PSA) elevation required hormonal therapy 5 years later. A pancreatic islet tumor had been previously identified; however, its details were unavailable. He was presented to the emergency department 24 h after receiving the first gonadotropin‐releasing hormone agonist injection. He showed severe headache, general fatigue, diplopia, and ptosis of the right eye. Brain MRI revealed a right deviated suprasellar pituitary adenoma with hemorrhagic infarction. He was conservatively treated with high‐dose steroids; symptoms improved within 1 week. Conclusion Clinicians should be aware of the association of pituitary apoplexy with the use of gonadotropin‐releasing hormone agonist and should ask about the patient's past history of multiple endocrine neoplasia (MEN).
Fujimura et al. (Fri,) studied this question.