Rare case of Cushing’s disease due to double ACTH-producing adenomas, one located in the pituitary gland and one into the stalk

التفاصيل البيبلوغرافية
العنوان: Rare case of Cushing’s disease due to double ACTH-producing adenomas, one located in the pituitary gland and one into the stalk
المؤلفون: Alessia Dolci, Marco Mendola, Dario Bauer, Lanfranco Piscopello, Giustino Tomei, Bruno Ambrosi, Sabrina Corbetta
المصدر: HORMONES.
بيانات النشر: Springer Science and Business Media LLC, 2002.
سنة النشر: 2002
مصطلحات موضوعية: Adenoma, Adult, Pituitary gland, Pathology, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Neoplasms, Multiple Primary, Infundibulum, Anterior pituitary, Pituitary adenoma, medicine, Enlarged pituitary gland, Humans, Pituitary ACTH Hypersecretion, Pituitary stalk, business.industry, General Medicine, Cushing's disease, medicine.disease, Magnetic Resonance Imaging, ACTH-Secreting Pituitary Adenoma, medicine.anatomical_structure, Pituitary Gland, Female, business
الوصف: We describe a patient affected with Cushing’s disease due to the presence of double pituitary adenomas, one located within the anterior pituitary and the other in the infundibulum associated with a remnant of the Rakthe’s pouch. Cure was obtained only after the infundibulum lesion was surgically removed. CASE REPORT : a 38-years-old female presented with unexplained weight gain, hirsutism, amenorrhea, asthenia, recurrent cutaneous micotic infections and alopecia. Hormonal studies indicated Cushing’s disease and MRI showed an enlarged pituitary gland with a marked and homogeneous enhancement after injection of gadolinium and an enlarged infundibulum with a maximum diameter of 8 mm. As venous sampling of the inferior petrosal sinus after 10 µg iv desmopressin stimulation revealed a central to peripheral ACTH levels ratio consistent with a pituitary ACTH-secreting tumor, transphenoidal explorative surgery was performed and a 4-mm pituitary adenoma immunopositive for ACTH was disclosed and removed. Since postoperative hormonal evaluation showed persistent hypercortisolism, confirmed by dynamic tests, the patient again underwent surgery by transcranial access and the infundibulum mass was removed. Histology and immunochemistry were consistent with ACTH-secreting adenoma. Few months after the second operation cushingoid features were significantly reverted and symptoms improved. CONCLUSION: although Cushing’s patients bearing multiple adenomas have already been documented, the presence of two adenomas both immunohistochemically positive for ACTH is a very rare cause of Cushing’s disease and this is the first report of a case of double ACTH-producing adenomas, one located in the pituitary gland and one attached to the stalk.
تدمد: 1109-3099
DOI: 10.14310/horm.2002.1503
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e3156ba2458c8f551343ec78d54952bc
https://doi.org/10.14310/horm.2002.1503
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....e3156ba2458c8f551343ec78d54952bc
قاعدة البيانات: OpenAIRE
الوصف
تدمد:11093099
DOI:10.14310/horm.2002.1503