Pituitary Tumor Hemorrhage in Cushing Disease

spontaneous pituitary hemorrhage and necrosis (pitu-itary apoplexy) have been reported to occur in 9.5 % to 16.6 % of pituitary tumors (1-3). However, pituitary apo-plexy rarely develops in patients with Cushing disease. The clinical presentation of pituitary hemorrhage varies from no symptoms to a neurosurgical emergency in which structures in the sellar and parasellar regions are com-pressed (1-3). Transient hypopituitarism is common after pituitary apoplexy. Pituitary function may improve either spontaneously (4, 5) or after surgical decompression (6, 7). We describe two patients who developed adrenal insuf-ficiency and subsequently Cushing disease after hemor-rhage into adrenocorticotropin hormone (ACTH)-secret-ing pituitary microadenomas. To our knowledge, this ha