A 59-year old man, who had a hypertensive crisis during transsphenoidal surgery for a pituitary macroadenoma, was subsequently found to have an adrenal pheochromocytoma. A total of twenty-five cases describing the coexistence of a pituitary adenoma and pheochromocytoma have been reported in the literature over the past 40 years. Among pituitary tumors, acromegaly has been the most common. In an effort to identify the relationship between the two tumors, multiple theories have been suggested including fortuitous association, overlap or variants of MEN syndromes, and ectopic production of a trophic hormone by the pheochromocytoma. The high risk of mortality and morbidity associated with undiagnosed pheochromocytoma warrants careful attention to the possibility of such a coexistence.
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