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Acromegaly in a patient with normal pituitary gland and somatotropic adenoma located in the sphenoid sinus.
Endokrynol Pol. 2008 Jul-Aug; 59(4):348-51.EP

Abstract

Ectopic acromegaly is a very rare clinical entity occurring in less than 1% of acromegalic patients. In most cases it is caused by GHRH or rarely GH-secreting neoplasms. Even rarer are ectopic pituitary adenomas located in the sphenoid sinus or nasopharynx that originate from pituitary remnants in the craniopharyngeal duct. This dissertation presents the difficulties in visualizing GH-secreting adenoma located in the sphenoid sinus. A 55-year-old man had somatic features of acromegaly for several years. MRI imaging revealed a slightly asymmetric pituitary gland (14 yen 4 mm) without focal lesions. Simultaneously, a spherical mass, 10 mm in diameter, corresponding with ectopic microadenoma was demonstrated on the upper wall of the sphenoid sinus. The serum GH level was 4.3 mg/l, IGF-1 = 615 mg/l, and a lack of GH suppression with oral glucose was proven. After preliminary treatment with a long-acting somatostatin analogue, transsphenoidal pituitary tumour removal was performed. Histopathological, electron microscopical and immunohistochemical analysis revealed densely granulated somatotropic pituitary adenoma: GH(+), PRL(-), ACTH(-), TSH(-), FSH(-), LH(-), MIB1 < 1%, SSTR3(+) and SSTR5(+). Post-surgical evaluation showed normal pituitary MRI scans, GH and IGF-1 levels 0.18 mug/l and 140 mg/l, respectively, as well as normal GH suppression with oral glucose. The careful analysis of possible pituitary embryonic malformations points out their significance for proper localization of extrapituitary adenomas.

Authors+Show Affiliations

Department of Endocrinology, Medical University, Lublin, Poland. mariakurowska@op.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18777506

Citation

Kurowska, Maria, et al. "Acromegaly in a Patient With Normal Pituitary Gland and Somatotropic Adenoma Located in the Sphenoid Sinus." Endokrynologia Polska, vol. 59, no. 4, 2008, pp. 348-51.
Kurowska M, Tarach JS, Zgliczyński W, et al. Acromegaly in a patient with normal pituitary gland and somatotropic adenoma located in the sphenoid sinus. Endokrynol Pol. 2008;59(4):348-51.
Kurowska, M., Tarach, J. S., Zgliczyński, W., Malicka, J., Zieliński, G., & Janczarek, M. (2008). Acromegaly in a patient with normal pituitary gland and somatotropic adenoma located in the sphenoid sinus. Endokrynologia Polska, 59(4), 348-51.
Kurowska M, et al. Acromegaly in a Patient With Normal Pituitary Gland and Somatotropic Adenoma Located in the Sphenoid Sinus. Endokrynol Pol. 2008 Jul-Aug;59(4):348-51. PubMed PMID: 18777506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acromegaly in a patient with normal pituitary gland and somatotropic adenoma located in the sphenoid sinus. AU - Kurowska,Maria, AU - Tarach,Jerzy S, AU - Zgliczyński,Wojciech, AU - Malicka,Joanna, AU - Zieliński,Grzegorz, AU - Janczarek,Marzena, PY - 2008/9/9/pubmed PY - 2009/2/6/medline PY - 2008/9/9/entrez SP - 348 EP - 51 JF - Endokrynologia Polska JO - Endokrynol Pol VL - 59 IS - 4 N2 - Ectopic acromegaly is a very rare clinical entity occurring in less than 1% of acromegalic patients. In most cases it is caused by GHRH or rarely GH-secreting neoplasms. Even rarer are ectopic pituitary adenomas located in the sphenoid sinus or nasopharynx that originate from pituitary remnants in the craniopharyngeal duct. This dissertation presents the difficulties in visualizing GH-secreting adenoma located in the sphenoid sinus. A 55-year-old man had somatic features of acromegaly for several years. MRI imaging revealed a slightly asymmetric pituitary gland (14 yen 4 mm) without focal lesions. Simultaneously, a spherical mass, 10 mm in diameter, corresponding with ectopic microadenoma was demonstrated on the upper wall of the sphenoid sinus. The serum GH level was 4.3 mg/l, IGF-1 = 615 mg/l, and a lack of GH suppression with oral glucose was proven. After preliminary treatment with a long-acting somatostatin analogue, transsphenoidal pituitary tumour removal was performed. Histopathological, electron microscopical and immunohistochemical analysis revealed densely granulated somatotropic pituitary adenoma: GH(+), PRL(-), ACTH(-), TSH(-), FSH(-), LH(-), MIB1 < 1%, SSTR3(+) and SSTR5(+). Post-surgical evaluation showed normal pituitary MRI scans, GH and IGF-1 levels 0.18 mug/l and 140 mg/l, respectively, as well as normal GH suppression with oral glucose. The careful analysis of possible pituitary embryonic malformations points out their significance for proper localization of extrapituitary adenomas. SN - 0423-104X UR - https://www.unboundmedicine.com/medline/citation/18777506/Acromegaly_in_a_patient_with_normal_pituitary_gland_and_somatotropic_adenoma_located_in_the_sphenoid_sinus_ L2 - http://www.endokrynologia.polska.viamedica.pl/en/zamow_art_pdf.phtml?id=25&amp;indeks_art=352 DB - PRIME DP - Unbound Medicine ER -