Pituitary apoplexy is characterized by abrupt onset of haemorrhage or non-haemorrhagic
infarction of a
pituitary adenoma. The clinical features include acute onset severe
headache, visual field defects, meningeal irritation,
ophthalmoplegia and
hypopituitarism. The
pituitary apoplexy may be clinically silent in ∼25% of patients. We report a case of
acromegaly due to pituitary macroadenoma. The patient was started on long-acting
octreotide therapy. On 3-month follow-up, the patient showed clinical and biochemical remission and the magnetic resonance imaging (MRI) of the brain showed subclinical haemorrhage and resolution of tumour. The
octreotide therapy was stopped. On 6-month follow-up, the patient was still in remission and the MRI of brain revealed non-enhancing mixed intensities haemorrhagic and cystic areas of the pituitary gland. In our patient, whether spontaneous remission of
acromegaly due to subclinical pituitary haemorrhage was coincidental or due to long-acting
octreotide therapy is still a dilemma. We report this case because of rarity and clinical importance of this unusual occurrence.