Delayed postoperative pituitary apoplexy after endoscopic transsphenoidal resection of a giant pituitary macroadenoma

Postoperative pituitary apoplexy is rare and usually occurs in the immediate postoperative period (within 12 hours) after subtotal resection of giant pituitary macroadenomas with fatal outcomes. We describe a unique patient with pituitary apoplexy occurring in a delayed fashion on the third postoperative day. Early detection and emergent endoscopic transsphenoidal exploration resulted in gross total removal of the residual tumor, decompression of the optic chiasm, and a favorable neurologic outcome.