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Changes in hormone production of a recurrent silent corticotroph adenoma of the pituitary: a histologic, immunohistochemical, ultrastructural, and tissue culture study.

Abstract
A 19-year-old man with blurred vision, headache, and no signs or symptoms of hormone excess was found to have a pituitary adenoma. The tumor was removed by a transfrontal approach. He had postoperative radiation therapy, but subsequently had three recurrences, all removed surgically. By histology, the tumor was a chromophobic, slightly acidophilic pituitary adenoma. Immunohistochemistry revealed the presence of adrenocorticotropin (ACTH) in all four biopsies, alpha-subunit of glycoprotein hormones, and, to a lesser extent, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the third and fourth tumor resection specimens. Ultrastructurally, the tumor had typical features of a silent corticotroph adenoma subtype 2. In tissue culture, the second, third, and fourth specimens released ACTH, alpha-subunit, FSH, and LH and responded to corticotropin-releasing hormone with increased release of ACTH, alpha-subunit, FSH, and LH. To our knowledge only one silent corticotroph adenoma has been reported previously which expressed plurihormonality. Change in immunohistochemical profile in malignant tumors is a well-known phenomenon; however, it was not reported previously in benign pituitary adenomas. The factors accounting for changing tumor phenotype are unknown.
AuthorsI Felix, S L Asa, K Kovacs, E Horvath
JournalHuman pathology (Hum Pathol) Vol. 22 Issue 7 Pg. 719-21 (Jul 1991) ISSN: 0046-8177 [Print] United States
PMID1649119 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Adrenocorticotropic Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
Topics
  • Adenoma (metabolism, surgery, ultrastructure)
  • Adrenocorticotropic Hormone (metabolism)
  • Adult
  • Culture Techniques
  • Follicle Stimulating Hormone (metabolism)
  • Humans
  • Luteinizing Hormone (metabolism)
  • Male
  • Neoplasm Recurrence, Local
  • Pituitary Neoplasms (metabolism, surgery, ultrastructure)

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