Recurrence of Cushing's disease after long-term remission due to pituitaryapoplexy

We encountered a case with long-term remission of Gushing's disease due to pituitary apoplexy. The apoplexy of pituitary adenoma secreting adrenocorti cotropin hormone was diagnosed by successive and timely magnetic resonance imaging when the symptoms of the patient were not yet severe and anterior p ituitary dysfunction was only a transient reduction of growth hormone secre tion. Seven years after the first episode of pituitary apoplexy, hypercorti cism recurred, and pituitary magnetic resonance imaging showed a regrowth o f the pituitary adenoma. A spontaneous remission of Gushing's disease witho ut significant visual, neurologic or hormonal defects seems to be a much mo re common phenomenon than has been previously suggested. Cases with relapse after spontaneous remission of Gushing's disease are rare and the duration of remission in previous reports was within 5 years. We observed such a pa tient with a 7 year-remission caused by pituitary apoplexy. We consider tha t a careful long-term follow-up is required for patients with Gushing's dis ease whose remission was due to pituitary apoplexy.