Panhypopituitarism in a young drug abuser.

An intoxicated young man returned home from a drinking party and collapsed and died in his mother's presence. Three weeks earlier, he had been released from prison, having served a sentence for possession and sale of "street drugs". At the time of his release, he and his friends had gathered together for a celebration at which drugs were used. At the autopsy table, there was initial evidence of an intrasellar hemorrhage of recent onset with ablation of the adenohypophysis. At first the prosectors considered the case to be one of drug-induced pituitary "apoplexy". However, there was subsequent autopsy evidence of chronic panhypopituitarism. The intrasellar lesion proved to be a Rathke-cleft cyst of dysontogenetic origin, probably unrelated to drug abuse. This case is presented as an example of the increasing complexities encountered by the forensic pathologist in a world of increasing numbers of available toxic substances.