Relapsing, remitting hypercortisolism in Cushing’s disease due to intratumoral hemorrhages in pituitary microadenoma

We report two patients with Cushing’s disease (CD) from adrenocorticotropic hormone-secreting microadenomas in whom intralesional hemorrhage caused an episodic, remitting and relapsing pattern of hypercortisolism. To our knowledge this is the first report of patients in whom hemorrhage within a microadenoma caused cyclic CD. Both patients were treated successfully with transsphenoidal surgery.