# Cocaine‐Induced Apoplexy of a GH‐Secreting Pituitary Tumor

## TL;DR

A man with acromegaly experienced remission after a pituitary tumor bleed caused by cocaine use.

## Contribution

This is the first reported case of acromegaly remission following a cocaine-induced pituitary apoplexy.

## Key findings

- The patient's acromegaly symptoms remitted after a pituitary apoplexy.
- The apoplexy was likely induced by cocaine consumption.
- The patient's IGF-1 levels were within the normal range, indicating remission.

## Abstract

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.