Monomorphous Plurihormonal Pituitary Adenoma of Pit-1 Lineage in a Giant Adolescent with Central Hyperthyroidism
| Autor: | Sylvia L. Asa, Bernardo Dias Pereira, Jorge Portugal, Ozgur Mete, Ana Oliveira, Luísa Raimundo |
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| Rok vydání: | 2015 |
| Předmět: |
Adenoma
Male endocrine system Pathology medicine.medical_specialty Adolescent endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Thyrotropin 030209 endocrinology & metabolism Context (language use) Hyperthyroidism Gigantism Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Endocrinology Microscopy Electron Transmission Pituitary adenoma Biomarkers Tumor medicine Humans Pathological Transsphenoidal surgery business.industry Pituitary tumors General Medicine medicine.disease Immunohistochemistry Somatostatin 030220 oncology & carcinogenesis Growth Hormone-Secreting Pituitary Adenoma Neoplasm Recurrence Local Transcription Factor Pit-1 business |
| Zdroj: | Endocrine Pathology. 27:25-33 |
| ISSN: | 1559-0097 1046-3976 |
| DOI: | 10.1007/s12022-015-9395-2 |
| Popis: | Thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare at the pediatric age and no cases of co-secretion with other pituitary hormones in these tumors have been described in this age range. We present a case of a monomorphous plurihormonal pituitary adenoma that co-secreted TSH and GH in a pediatric patient. A 13-year-old male presented with increasing height velocity (17.75 cm/year, 9.55SD), weight loss, and visual impairment. Initial biochemical evaluations revealed secondary hyperthyroidism. A giant pituitary tumor compressing the surrounding structures was detected by magnetic resonance, and a transsphenoidal surgery was initially performed. Pathological examinations revealed an atypical, monomorphous plurihormonal Pit-1 lineage tumor with mixed features of silent subtype 3 adenoma and acidophil stem cell adenoma. In the postoperative period, secondary hyperthyroidism recurred with high levels of both GH and IGF1. In addition, due to tumor re-growth, a multimodality treatment plan was undertaken including surgery, somatostatin analogs, and radiotherapy. We report the first pediatric case of a plurihormonal TSH- and GH-secreting pituitary adenoma, further expanding the clinical manifestations of pediatric pituitary tumors. Comprehensive pathological evaluation and close follow-up surveillance are crucial to the prompt delivery of the best therapeutic options in the context of this particularly aggressive pituitary tumor. |
| Databáze: | OpenAIRE |
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