Spontaneous postpartum regression of pituitary mass with return of function

A 37-year-old woman undergoing endocrine evaluation during her seventh pregnancy because of headaches, weakness, and hyponatremia was found to have central hypoadrenalism and hypothyroidism. Computed tomography showed a pituitary mass with suprasellar extension but her visual fields were intact. She was treated conservatively with hydrocortisone acetate and levothyroxine sodium until 38 weeks of gestation, when healthy twins were delivered by cesarean section. A few months later, her pituitary function improved, with a significant increase in the adrenocorticotropic hormone level, normal values of basal thyroid-stimulating hormone, growth hormone, and gonadotropins and of their functional reserves, and only a slight elevation in the prolactin level. A repeated computed tomographic scan showed disappearance of the pituitary mass.