Cocaine-Induced Apoplexy of a GH-Secreting Pituitary Tumor.

A 25-year-old previously healthy man presents to the clinic with a severe headache after cocaine consumption. Physical examination revealed acromegaloid features, and the hormonal profile revealed an IGF-1 of 308 ng/mL (40.8 nmol/L) (normal reference range 197-333 ng/mL; 17.8-45.6). An MRI showed a heterogeneous, cystic lesion of the pituitary gland with hematic contents, consistent with the diagnosis of a pituitary apoplexy. Considering the normal IGF-1 level, the patient was classified to be in remission, which deems it unnecessary to initiate pharmacologic or surgical treatment. Remission of acromegaly after a pituitary apoplexy is an extremely rare event, and pituitary apoplexy after cocaine consumption is also anecdotal. We present the first case of remission of acromegaly after a cocaine-induced pituitary apoplexy.