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Double pituitary adenoma--two case reports

S Kannuki1, K Matsumoto, T Sano

  • 1Department of Neurological Surgery, School of Medicine, University of Tokushima.

Neurologia Medico-Chirurgica
|November 1, 1996
PubMed
Summary
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Multiple pituitary adenomas with distinct histological types were observed in two patients. Careful examination is crucial for diagnosing these rare dual-adenoma cases, especially in endocrine neoplasia.

Area of Science:

  • Endocrinology
  • Pathology
  • Oncology

Background:

  • Pituitary adenomas are common tumors, but multiple adenomas with distinct histological types are rare.
  • Multiple endocrine neoplasia type 1 (MEN1) is a genetic disorder predisposing individuals to pituitary, parathyroid, and pancreatic tumors.

Observation:

  • A 43-year-old male with MEN1 developed acromegaly due to a growth hormone-releasing hormone (GHRH)-producing pancreatic tumor, followed by pituitary adenomas (GH cell and null cell).
  • A 39-year-old male without MEN1 presented with a non-functioning pituitary adenoma exhibiting two distinct histological types (silent GH cell and silent gonadotroph adenoma).

Findings:

  • The first patient's acromegaly resolved after pancreatic tumor resection, but GH levels rose, leading to pituitary adenoma formation.
  • Histological examination revealed dual pituitary adenomas in both patients, highlighting the complexity of pituitary tumor presentation.

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Implications:

  • This case series underscores the importance of thorough histological examination to identify multiple pituitary adenomas with varying cell types.
  • Recognizing dual adenomas is critical for accurate diagnosis and appropriate management of patients with pituitary disorders, particularly those with underlying genetic conditions like MEN1.