TWO SYNCHRONOUS PITUITARY ADENOMAS CAUSING CUSHING DISEASE AND ACROMEGALY

Area of Science:

• Endocrinology
• Oncology
• Molecular Biology

Background:

• Synchronous pituitary adenomas are rare, and their distinct molecular origins remain poorly understood.
• This report focuses on a unique case of two concurrent pituitary adenomas with differing cellular lineages.

Observation:

• A patient presented with symptoms of both Cushing disease and growth hormone excess.
• Initial surgery revealed a corticotroph adenoma; a second, smaller somatotroph adenoma was subsequently discovered and resected.
• Pathological analysis confirmed distinct molecular profiles for each adenoma, including differential S-100 protein expression.

Findings:

• The corticotroph adenoma expressed adrenocorticotropic hormone (ACTH) but not growth hormone (GH).
• The somatotroph adenoma expressed GH but not ACTH.
• Genetic analysis did not reveal known germline mutations associated with pituitary adenoma syndromes.

Implications:

• This case provides evidence that synchronous pituitary adenomas can originate from distinct molecular lineages.
• Understanding these differing origins is crucial for accurate diagnosis and targeted therapeutic strategies for complex pituitary tumors.