scholarly journals Pituitary gigantism. The possibility of medical treatment

2020 ◽  
Vol 10 (5) ◽  
pp. 93-99
Author(s):  
Ljudmila V. Tyrtova ◽  
Aleksej S. Olenev ◽  
Natalja V. Parshina ◽  
Christina V. Skobeleva
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Medical Treatment ◽  
Genetic Diseases ◽  
Laboratory Data ◽  
Carney Complex ◽  
The Body ◽  
Genetic Defects ◽  
Extended Action ◽  
Target Values

Pituitary gigantism is a disease caused by an excess of growth hormone and characterized by tallness with a proportional increase in all parts of the body. Almost always in patients with pituitary gigantism found pituitary adenoma, producing growth hormone (somatotropin). In rare cases, there is excess production of somatoliberin by the hypothalamus or tumors outside the brain. Somatotropinoma can be sporadic or caused by a disease with genetic defects: multiple endocrine neoplasia type 1, McCuneAlbright syndrome, Carney complex, X-LAG syndrome, AIP-mutation. All associated with genetic defects somatotropinoma more invasive and less amenable to drug therapy than sporadic. Clinical recommendations (protocols) for the treatment of pituitary gigantism in children currently does not exist. The issue of preliminary medical treatment to improve the outcome of neurosurgical interventions has not been resolved, and further methodologically based studies are needed to clarify this point. The article presents a clinical case of pituitarygigantism caused by pituitary adenoma, which produces growth hormone in a 12-year-old boy. The diagnosis was established on the basis of clinical and anamnestic, laboratory data and magnetic resonance imaging. Clinical and laboratory manifestations of hypopituitarism and diabetes insipidus, visual field disorders, neurological symptoms, as well as signs of genetic diseases in the patient were not noted. Treatment with bromocriptin gave a partial positive effect: the size of the formation in the pituitary gland decreased, but the target hormonal parameters were not achieved. A trial administration of octreotide subcutaneously was carried out, as a result of which the level of growth hormone decreased to the target values, no side effects of the drug were noted, which led to the choice of a conservative method as the first line of therapy. Thedecision to treat with bromocryptine in combination with octreotide extended action. The dynamics of tumor sizeonthebackgroundofconservative therapy will answer the question of the need for subsequent neurosurgical treatment.

scholarly journals MON-313 Thyrotropin-Secreting Pituitary Tumors: Clinical Features, Diagnostic Criteria and Treatment Outcomes in 28 Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Diana A Dimitrova ◽  
Evgeniy T Abdullin ◽  
Elena G Przhiyalkovskaya ◽  
Andrey Yu. Grigoriev ◽  
Vilen N Azizyan ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Thyroid Hormones ◽  
Medical Treatment ◽  
Combined Treatment ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Case Series ◽  
Pituitary Tumors ◽  
Mean Value ◽  
Somatostatin Analogue

Abstract Introduction Thyrotropin-secreting pituitary adenoma (TSH-oma) is a rare cause of thyrotoxicosis and represents 0.5-3% of all pituitary adenomas. Given the rarity of the disease and the lack of extensive clinical experience in world practice, the analysis of each case of TSH-secreting pituitary tumors is extremely relevant. Materials and methods: We enrolled consecutive patients with TSH secreting pituitary adenoma. TSH (0,25-3,5 mIU/L), FT4 (9-20 pmol/l) FT3 (2,5-5,5 pmol/l) were measured by Architect i2000SR (Abbott Laboratories, Abbott Park, Illinois, U.S.A). An octreotide test consisted of injecting short-acting somatostatin analogue (SSA) at a dose of 100 μg 3 times a day subcutaneously during 3 days or long-acting SSA 20 mg in 28 days minimum for two months and measuring thyroid profile blood tests before and at the end of the test. MRI was performed on GE Optima MR450w 1.5T. Results: We present 28 case series with TSH-omas followed in our center from 2010 to 2019, the median age - 46 (from 10 to 71 years) with a predominance of a female (21 cases) over a male (7 cases). Clinical manifestations included cardiac arrhythmias (82.1%), neurological changes (60.7%), visual impairment (39.3%), osteoporosis (28.6%), hypopituitarism (7.1%). At first admission, 17 patients had increased TSH, FT3 and FT4; in 7 patients - FT3 and FT4 only, and in 4 - an increase was in one of the hormones; mean value of TSH was 5,04 mIU/L, FT4 - 24,46 pmol/l, FT3 - 8,9 pmol/l. SSBG, CTx, osteocalcin were elevated in 60.9%, 57.9% and 31.6% of cases, respectively. In 88.5% of cases octreotide test led to thyroid hormones normalization. On MRI macroadenomas was registered in 67.9%. In 12 patients, diagnosis was confirmed by immunohistochemical examination. In 12 patients, the diagnosis verification was based on remission after surgical and medical treatment. In the remaining four cases, the diagnosis was made on clinical and laboratory data, however, confirmation was inconceivable due to inefficacy of medical treatment. Remission was achieved in 23 patients: 17 of 21 after neurosurgery (81%), 3 of 7 after primary administration of SSA, and 3 after administration of SSA after surgery (100% remission in cases of combined treatment and 42.9% of monotherapy); 3 out of 5 patients who did not achieve remission were lost for observation. Two patients died: in one case due to the brain herniation and cachexia in active thyrotoxicosis. In second case, the patient developed a mental disorder (catatonia) after the second transphenoidal adenomectomy, which led to death. Conclusion The diagnosis of TSH-oma should be based on all thyroid hormones assessment, since biochemical thyrotoxicosis can manifest itself in various ways. The most effective treatment is transphenoidal adenomectomy. If a neurosurgery is not effective or contraindicative, preoperative preparations SSA can be used.

Association of pituitary adenoma with neuronal christoma: A TEM study

1994 ◽  
Vol 52 ◽  
pp. 232-233
Author(s):  
Eva Horvath ◽  
Kalman Kovacs ◽  
B. W. Scheithauer ◽  
R. V. Lloyd ◽  
H. S. Smyth
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Pituitary Tumor ◽  
Nervous Tissue ◽  
Alternative Explanation ◽  
Growth Hormone Releasing Hormone ◽  
Cell Hyperplasia ◽  
Releasing Hormone ◽  
Secretory Neurons

The association of a pituitary adenoma with nervous tissue consisting of neuron-like cells and neuropil is a rare abnormality. In the majority of cases, the pituitary tumor is a chromophobic adenoma, accompanied by acromegaly. Histology reveals widely variable proportions of endocrine and nervous tissue in alternating or intermingled patterns. The lesion is perceived as a composite one consisting of two histogenetically distinct parts. It has been suggested that the neuronal component, morphologically similar to secretory neurons of the hypothalamus, may initiate adenoma formation by releasing stimulatory substances. Immunoreactivity for growth hormone releasing hormone (GRH) in the neuronal component of some cases supported this view, whereas other findings such as consistent lack of growth hormone (GH) cell hyperplasia in the lesions called for alternative explanation.Fifteen tumors consisting of a pituitary adenoma and a neuronal component have been collected over a 20 yr. period. Acromegaly was present in 11 patients, was equivocal in one, and absent in 3.

Co-secreting TSH and growth hormone pituitary adenoma

2019 ◽  
Author(s):  
Hatem Eid ◽  
B Andrabi ◽  
R Ismail ◽  
H Nizar ◽  
G Maltese ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma

Antitumor effects of growth hormone-releasing hormone (GHRH) antagonists in ACTH and GH-secreting pituitary adenoma cell lines

2019 ◽  
Author(s):  
Alessandro Fanciulli ◽  
Iacopo Gesmundo ◽  
Giacomo Gamba ◽  
Justo P Castano ◽  
Raul M Luque ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Cell Lines ◽  
Growth Hormone Releasing Hormone ◽  
Antitumor Effects ◽  
Releasing Hormone ◽  
Adenoma Cell ◽  
Ghrh Antagonists

Kajian Kandungan Fe dalam Air Tanah Terhadap Kadar Ekskresi Yodium dalam Urin pada Anak Sekolah di Desa Cerme Kecamatan Panjatan Kabupaten Kulon Progo

2017 ◽  
Vol 19 (1) ◽  
pp. 7-11
Author(s):  
Vivi Linda Fristianti ◽  
Nur Hidayat ◽  
Slamet Iskandar
Keyword(s):  
Elementary School ◽  
Ground Water ◽  
School Children ◽  
Laboratory Data ◽  
Simple Random Sampling ◽  
Optimal Level ◽  
The Body ◽  
Design Data ◽  
Cross Sectional ◽  
Fe Content

Background : IDD problem is a serious problem, 33% of districts in Indonesia are endemic, 21% of endemic mild, moderate endemic 5% and 7% by weight endemic. Urine Iodine Excretion (EYU) illustrates the iodine intake of a person, because 90% of the iodine that enter the body are excreted through the urine. Blocking agents are substances certain minerals such as iron, manganese and calcium, which can bind iodine in groundwater. Objectives : This study aims to determine the relationship of Fe content in ground water sources against EYU levels in school children in the village of the District Cerme Panjatan Kulon Progo. Methods : An observational analytic research with cross sectional design. Data collection is done in May - June 2015. Location research Elementary School Cerme, District Panjatan Kulon Progo. The subjects of the study as many as 34 children in elementary school classroom Cerme 3, 4 and 5 were taken by simple random sampling. Well water and urine samples taken students then tested the iron in the Central Health Laboratory test Yogyakarta and iodine in urine in Magelang BP2GAKY Laboratory. Data analysis using Spearman Range test with significancy level : 0.05. Result : Fe content in the ground water is below the normal threshold is <0.3 mg / L. While levels EYU school children who are under the optimal level of 5.9%, the optimal level of 32.4%, and the optimum levels above 61.8% (optimal: 100 - 199μg / L). Conclusion : There was no significant relationship between the Fe content in groundwater with levels of EYU in school children in District Panjatan Kulon Progo (p = 0.447).   Keywords: Fe, EYU

Pituitary Adenoma with Mucin Cells in a Man with an Unusual Presentation of Carney Complex

2013 ◽  
Vol 24 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Gabrielle A. Yeaney ◽  
Jillene M. Brathwaite ◽  
Matthew L. Dashnaw ◽  
G. Edward Vates ◽  
Laura M. Calvi
Keyword(s):  
Pituitary Adenoma ◽  
Carney Complex ◽  
Unusual Presentation

Pituitary adenoma producing growth hormone and adrenocorticotropin: a histological, immunocytochemical, electron microscopic, and in situ hybridization study

1998 ◽  
Vol 88 (6) ◽  
pp. 1111-1115 ◽  
Author(s):  
Kalman Kovacs ◽  
Eva Horvath ◽  
Lucia Stefaneanu ◽  
Juan Bilbao ◽  
William Singer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
In Situ Hybridization ◽  
Pituitary Adenoma ◽  
Immunoelectron Microscopy ◽  
Secretory Granules ◽  
Cell Types ◽  
Content Type ◽  
Separate Cell ◽  
Fine Print

✓ The authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumor, which was removed from a 62-year-old man with acromegaly, was studied by histological and immunocytochemical analyses, transmission electron microscopy, immunoelectron microscopy, and in situ hybridization. When the authors used light microscopy, the tumor appeared to be a bimorphous mixed pituitary adenoma composed of two separate cell types: one cell population synthesized GH and the other ACTH. The cytogenesis of pituitary adenomas that produce more than one hormone is obscure. It may be that two separate cells—one somatotroph and one corticotroph—transformed into neoplastic cells, or that the adenoma arose in a common stem cell that differentiated into two separate cell types. In this case immunoelectron microscopy conclusively demonstrated ACTH in the secretory granules of several somatotrophs. This was associated with a change in the morphological characteristics of secretory granules. Thus it is possible that the tumor was originally a somatotropic adenoma that began to produce ACTH as a result of mutations that occurred during tumor progression.

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