Abstract | OBJECTIVE: METHODS: We report the clinical, laboratory, imaging, and pathology findings of a patient symptomatic from a plurihormonal pituitary adenoma and describe her outcome after surgical treatment. RESULTS: A 60-year-old woman presented to the emergency department with headaches, blurry vision, fatigue, palpitations, sweaty hands, and weight loss. Her medical history was notable for hyperthyroidism, treated intermittently with methimazole. Magnetic resonance imaging disclosed a pituitary macroadenoma (2.3 by 2.2 by 2.0 cm), and preoperative blood studies revealed elevated levels of TSH at 6.11 mIU/L, free thyroxine at 3.6 ng/dL, and free triiodothyronine at 6.0 pg/mL. She underwent an uncomplicated transsphenoidal resection of the pituitary adenoma. Immunostaining of tumor tissue demonstrated positivity for not only TSH but also growth hormone, follicle-stimulating hormone, prolactin, and α-subunit. The Ki-67 index of the tumor was estimated at 2% to 5%, and DNA repair enzyme O6-methylguanine-DNA methyltransferase immunostaining was mostly negative. Electron microscopy showed the ultrastructural phenotype of a glycoprotein-producing adenoma. Postoperatively, her symptoms and hyperthyroidism resolved. CONCLUSION:
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Authors | Cynthia T Luk, Kalman Kovacs, Fabio Rotondo, Eva Horvath, Michael Cusimano, Gillian L Booth |
Journal | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
(Endocr Pract)
2012 Sep-Oct
Vol. 18
Issue 5
Pg. e121-6
ISSN: 1934-2403 [Electronic] United States |
PMID | 22441009
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Prolactin
- Follicle Stimulating Hormone
- Thyrotropin
- Growth Hormone
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Topics |
- Female
- Follicle Stimulating Hormone
(metabolism)
- Growth Hormone
(metabolism)
- Humans
- Middle Aged
- Pituitary Neoplasms
(metabolism, surgery)
- Prolactin
(metabolism)
- Thyrotropin
(metabolism)
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