{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:15:13Z","timestamp":1783487713619,"version":"3.55.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are rare endocrine neoplasms. Pituitary apoplexy, caused by acute hemorrhage or infarction within the tumor, is an uncommon complication. Pediatric cases of ACTH-secreting adenomas with apoplexy are exceptionally rare, with limited understanding of their clinical and imaging manifestations. This report aims to enhance diagnostic awareness through a detailed case analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 13-year-old boy presented with acute-onset severe headache, anuria, hypertensive crisis (180\/120 mmHg), and rapid weight gain (20\u00a0kg over 2 months). Biochemical evaluation revealed elevated ACTH (190 pg\/mL), disrupted cortisol rhythm, and hypokalemia (2.16\u20133.0 mmol\/L). Pituitary magnetic resonance imaging (MRI) demonstrated a 6mm\u00d75 mm cystic lesion in the left adenohypophysis with mixed T1\/T2 signals and no post-contrast enhancement, consistent with apoplexy. Histopathology confirmed an ACTH-secreting adenoma. Transsphenoidal resection and hormone replacement achieved stable remission at the 3-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric ACTH-secreting pituitary apoplexy presents diagnostic challenges due to nonspecific symptoms and atypical imaging features. MRI remains pivotal for initial evaluation, though histopathology is confirmatory. Early surgical intervention and hormonal management are critical for favorable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1894223","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:34:56Z","timestamp":1783485296000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Pediatric ACTH-secreting pituitary adenoma presenting with hypertension and anuria"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaxin","family":"Li","sequence":"first","affiliation":[{"name":"School of Medicine, Jianghan University","place":["Wuhan, China"]},{"name":"Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xia","sequence":"additional","affiliation":[{"name":"Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxing","family":"Wu","sequence":"additional","affiliation":[{"name":"Wuhan University of Science and Technology School of Medicine","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yapd.2021.05.007","article-title":"Pituitary tumors in children","volume":"68","author":"Alter","year":"2021","journal-title":"Adv Pediatr"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119374800.ch13","article-title":"Pituitary apoplexy","volume":"36","author":"Briet","year":"2015","journal-title":"Endocr Rev"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2024.103001","article-title":"Diagnosis and treatment of pituitary apoplexy, a true endocrine emergency","volume":"55","author":"Moscona-Nissan","year":"2024","journal-title":"Arch Med Res"},{"key":"B4","article-title":"Cushing's disease: a multidisciplinary overview of the clinical features, diagnosis, and treatment","volume":"9","author":"Buliman","year":"2016","journal-title":"J Med Life"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-024-01412-0","article-title":"Pituitary apoplexy: a systematic review of non-gestational risk factors","volume":"27","author":"Kajal","year":"2024","journal-title":"Pituitary"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01043-1","article-title":"Suprasellar pituitary adenomas: a 10-year experience in a single tertiary medical center and a literature 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Cushing\u2019s disease: a guideline update","volume":"9","author":"Fleseriu","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2017.04.012","article-title":"Pituitary imaging","volume":"46","author":"Pressman","year":"2017","journal-title":"Endocrinol Metab Clinics North America"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01071-x","article-title":"Ectopic pituitary adenomas: clinical features, diagnostic challenges and management","volume":"23","author":"Zhu","year":"2020","journal-title":"Pituitary"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1894223\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:35:20Z","timestamp":1783485320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1894223\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":12,"alternative-id":["10.3389\/fendo.2026.1894223"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1894223","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"article-number":"1894223"}}