Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 10 6 2026 06 03 275 279 EN Amna Malik Department of Diabetes and Endocrinology, Royal Stoke University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK. Cosmina Schiteanu Department of Diabetes and Endocrinology, Royal Stoke University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK. Simon Saw Department of Neurosurgery, Royal Stoke University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK. Biju Jose Department of Diabetes and Endocrinology, Royal Stoke University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK. 2026 03 09 2026 04 26 Pituitary apoplexy resulting from metastatic disease is an uncommon and rapidly progressive clinical presentation. This report details the case of a gentleman who presented with episodic severe headaches, a unilateral third nerve palsy, and progressive visual field loss. Initial blood tests indicated an abnormal pituitary hormone profile, while MRI imaging revealed a sellar mass exhibiting features consistent with apoplexy. Due to the acute threat to his vision, an urgent review was conducted at a pituitary multidisciplinary meeting, leading to endoscopic transsphenoidal decompression. The patient had a prior history of colorectal cancer, treated 18 months earlier and previously regarded as in remission. Subsequent histological analysis confirmed that the pituitary lesion was a metastasis from colorectal cancer. This case illustrates the diagnostic and therapeutic complexities inherent in managing this rare presentation. https://crcp.tums.ac.ir/index.php/crcp/article/view/1175 https://crcp.tums.ac.ir/index.php/crcp/article/download/1175/762