LAUSR

BACKGROUND Pituitary apoplexy may occur when a large tumour compresses or outgrows its nutrient supply, resulting in ischemic necrosis and haemorrhage. Although once deemed a neurosurgical emergency, increasing evidence suggests that conservative management of pituitary apoplexy leads to favourable neuroophthalmological and endocrinological outcomes as well. Spontaneous remission following pituitary apoplexy has been described in functioning pituitary adenomas, but it is a rare occurrence in non-functioning tumours. CASE Description: We report a male patient that presented with pituitary apoplexy of a nonfunctioning pituitary macroadenoma that was managed conservatively and treated hormonally for hypopituitarism during a 2-year follow-up period, with serial neuroimaging demonstrating significant tumour volume reduction with almost complete resolution resulting in partial empty sella. In addition, a short literature review was performed pertaining to the management of pituitary apoplexy with emphasis on a more conservative approach. CONCLUSIONS A subset of patients with pituitary apoplexy without altered consciousness and nonprogressive or mild ophthalmological deficits may be managed conservatively; however, lifelong periodic assessment, preferably by a specialized multidisciplinary pituitary team is essential until clinical outcomes become clear.