Cushing’s disease arising from a Clinically Non-Functioning Pituitary Adenoma after Cranial Trauma: A Case Report

Introduction: Silent corticotrope adenomas are a subtype of nonfunctioning pituitary adenomas that exceptionally differentiate into functioning adenomas due to multiple causes.

Case Report: A 42 years old man was referred to the department of Endocrinology in Hedi Chaker hospital in March 2021 with an incidental finding of pituitary adenoma. He had a history of traumatic brain injury 3 months earlier. Initial biochemical assays showed normal pituitary function. In September 2021, he was admitted to our department after showing florid Cushing’s disease features with severe hypokalemia. Hormonal dosages showed the lack of suppression of cortisol at the suppression tests with high levels of ACTH. The patient underwent pituitary surgery and a recovery was noted.

Conclusion: This is a rare case of silent corticotrope macroadenoma which became hyper secreting after a cranial trauma. Although the nature of the change which occurred in this tumor remains uncertain, it’s important to identify and follow closely the patient with such tumors because of the risk of evolution to a functional adenoma.