論文

査読有り
2020年3月

[Coexisting Symptomatic Adrenocorticotropic Hormone- and Growth Hormone-producing Double Pituitary Adenomas with Difficulty in Tumor Localization:A Case Report].

No shinkei geka. Neurological surgery
  • Yuhei Ito
  • Shinya Jinguji
  • Yusuke Sato
  • Taku Sato
  • Yuta Murakami
  • Masazumi Fujii
  • Jun Sakuma
  • Mariko Iwasaki
  • Akihiro Kudo
  • Michio Shimabukuro
  • Yuichiro Kiko
  • Masayasu Okada
  • Kiyoshi Saito
  • 全て表示

48
3
開始ページ
253
終了ページ
260
記述言語
日本語
掲載種別
研究論文(学術雑誌)
DOI
10.11477/mf.1436204171

Double functional pituitary adenomas are rare, and only a few cases of excessive clinical symptoms of both adrenocorticotropic hormone(ACTH)and growth hormone(GH)have been reported. We herein report a case of symptomatic ACTH-and GH-producing double pituitary adenomas, which were discretely located within the same pituitary gland. A 38-year-old woman presented with general malaise, facial and lower limb edema, unexplained weight gain, facial redness, acne, and nasal enlargement. Endocrinological findings matched with the diagnostic criteria for both acromegaly and Cushing's disease. Preoperative magnetic resonance imaging showed a 15-mm cyst-like lesion on the right side of the sellae surrounded by what was thought to be the normal contrast-enhancing pituitary gland. We assumed that the cyst-like lesion was an adenoma and performed endoscopic endonasal transsphenoidal surgery. However, the cyst-like lesion was a parenchymal tumor. Furthermore, the region we considered to be a normal pituitary gland was also found to be an adenoma. Both adenomas were completely resected. The postoperative blood analysis showed ACTH<1.0pg/dL, cortisol 1.8μg/dL, and insulin-like growth factor-1 60ng/mL, all of which were below reference levels. The histopathological examination confirmed the coexistence of two adenomas, a GH-producing adenoma and an ACTH-producing adenoma. We concluded that these adenomas were endocrinologically active within the pituitary gland. Thus, a diagnosis of double pituitary adenomas was made. When treating a patient with symptoms caused by hypersecretion of multiple anterior pituitary hormones, the possibility of coexisting multiple pituitary adenomas should be considered.

リンク情報
DOI
https://doi.org/10.11477/mf.1436204171
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32201395
ID情報
  • DOI : 10.11477/mf.1436204171
  • PubMed ID : 32201395

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