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Double pituitary adenomas: six surgical cases
1Department of Pathology, University of Tokushima School of Medicine, Japan.
Pituitary
|November 18, 2000
Summary
Double pituitary adenomas are rare in surgical cases, with 6 new instances found. Most patients had acromegaly, and at least one adenoma produced growth hormone (GH).
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- Double pituitary adenomas are infrequently reported in surgical specimens, despite their presence in approximately 1% of autopsy findings.
- This study investigates the characteristics and potential pathogenesis of double pituitary adenomas identified in surgical resections.
Observation:
- Six cases of double pituitary adenomas were identified from approximately 450 surgical specimens.
- The majority of patients (5/6) were male, aged 18-61, and presented with acromegaly or acrogigantism.
- Hyperprolactinemia was observed in 3 patients, and all cases involved at least one growth hormone (GH)-producing adenoma.
Findings:
- Adenomas were either from different (GH-PRL-TSH and FSH/LH) or the same (GH-PRL-TSH) pituitary adenoma groups.
- The high incidence of GH-producing adenomas may be linked to diverse histologic subtypes and cytokeratin immunostaining utility.
- Potential pathogenetic mechanisms include multicentric occurrence or clonal proliferation within a single adenoma, with genetic factors also considered.
Implications:
- Double pituitary adenomas may be more common in surgical settings than previously thought.
- Understanding their pathogenesis, including multicentricity, clonal evolution, and genetic predispositions, is crucial.
- Further molecular analyses are needed to elucidate the mechanisms of pituitary adenoma development and phenotypic differentiation.