Double Pituitary Adenoma —Two Case Reports—

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  • KANNUKI Seiji
    Department of Neurological Surgery, School of Medicine, the University of Tokushima
  • MATSUMOTO Keizo
    Department of Neurological Surgery, School of Medicine, the University of Tokushima
  • SANO Toshiaki
    Department of First Department of Pathology, School of Medicine, the University of Tokushima
  • SHINTANI Yasumi
    Department of First Department of Internal Medicine, School of Medicine, the University of Tokushima
  • BANDO Hiroshi
    Department of First Department of Internal Medicine, School of Medicine, the University of Tokushima
  • SAITO Shiro
    Department of First Department of Internal Medicine, School of Medicine, the University of Tokushima

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A 43-year-old male and a 39-year-old male presented with multiple pituitary adenomas with two distinct histological types. The first patient who had multiple endocrine neoplasia type 1 had developed acromegaly due to a growth hormone-releasing hormone (GHRH)-producing pancreatic tumor. Both plasma GHRH and growth hormone (GH) levels decreased to normal after resection of the pancreatic tumor. However, the plasma GH level gradually increased again and magnetic resonance imaging revealed pituitary adenoma formation. Histological examination revealed two different histological types of pituitary adenoma: GH cell adenoma and null cell adenoma. The second patient, with no such genetic condition, had a non-functioning pituitary adenoma. Histological examination revealed two different histological types of silent GH cell adenoma and silent gonadotroph adenoma. Careful histological examination is required to exclude the possibility of multiple pituitary adenomas.

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