Potential Association Between Anabolic Androgenic Steroid Abuse and Pituitary Apoplexy: A Case Report

IntroductionPituitary apoplexy (PA) is a rare, and potentially life-threatening condition, caused by hemorrhage or infarction into the pituitary gland with a rapid expansion of the contents of the sella turcica, associated with sudden intense headache, neurological and endocrinological deterioration. The identification of risk factors is crucial for prevention and optimal management. Herein we report a case of PA occurring 1 month after the initiation of anabolic androgenic steroid abuse for bodybuilding. Case ReportA 40-year-old male patient presents with abrupt onset headache associated with left partial third cranial nerve palsy. The MRI shows a sellar lesion involving left cavernous sinus with a heterogenous anterior aspect of the lesion with hemorrhagic zones in favor of PA. Endocrine work-up shows high testosterone level in patient who was using exogenous testosterone without a medical prescription for a month. ConclusionWe report a case of PA of a pituitary neuroendocrine tumor occurring shortly after AAS. The association between PA and AAS should be considered as a potential risk.

Automated summary

This case report describes a 40-year-old male patient who developed pituitary apoplexy shortly after using anabolic androgenic steroids for bodybuilding. The patient presented with sudden onset headache and left partial third cranial nerve palsy, confirmed by MRI findings. Endocrine work-up revealed high testosterone levels due to exogenous testosterone use without medical prescription. The association between pituitary apoplexy and anabolic androgenic steroids should be considered as a potential risk factor.