ArticleTherapeutic advances in endocrinology and metabolism2026
Recurrent pituitary apoplexy: experience from a national registry and review of the literature.
Article in Therapeutic advances in endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pituitary apoplexy (PA) is a neuroendocrine emergency characterized by acute hemorrhage or infarction of a pituitary adenoma. While its initial presentation and management are well documented, data on recurrent PA remain scarce. Objectives: To determine the prevalence, clinical characteristics, and predictors of recurrent PA in a national cohort, and to contextualize findings through a structured review of the literature. Design: Multicenter retrospective cohort study complemented by a structured literature review. Methods: We analyzed 274 patients from the Spanish Pituitary Apoplexy Registry (2010-2023) with complete follow-up. Recurrent PA was defined as a new acute episode with radiological evidence of hemorrhage or infarction within a previously affected lesion. Clinical, radiological, and treatment-related variables were compared between recurrent and non-recurrent cases. A complementary literature review identified published reports of recurrence. Results: Recurrent PA occurred in 9 patients (3.3%), including 6 of 214 with nonfunctioning adenomas (2.8%) and 3 of 60 with functioning adenomas (5.0%). Compared with nonrecurrent cases, patients with recurrence had significantly larger tumors (median 35 vs 25 mm; Conclusion: Recurrent PA is uncommon, affecting approximately 3% of patients with a prior apoplexy episode. Given the low frequency of recurrence, the associated factors identified should be interpreted cautiously and considered primarily hypothesis-generating. The second episode was not more severe than the initial event, and the long-term prognosis was favorable. Trial registration: Not applicable.
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