دورية أكاديمية
أعرض في EDS

Cushing Disease After Treatment of Nonfunctional Pituitary Adenoma: A Case Report and Literature Review.

التفاصيل البيبلوغرافية
العنوان: Cushing Disease After Treatment of Nonfunctional Pituitary Adenoma: A Case Report and Literature Review.
المؤلفون: Fang H; From the Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University (HF, JX, HF, LZ), Department of Neurosurgery (RT), Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences (CAMS) (HW); and Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (JZ)., Tian R, Wu H, Xu J, Fan H, Zhou J, Zhong L
المصدر: Medicine [Medicine (Baltimore)] 2015 Dec; Vol. 94 (51), pp. e2134.
نوع المنشور: Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Adenoma, Chromophobe/*complications , Pituitary ACTH Hypersecretion/*etiology , Pituitary ACTH Hypersecretion/*physiopathology , Pituitary Neoplasms/*complications, Adenoma, Chromophobe/surgery ; Adrenocorticotropic Hormone/blood ; Adult ; Circadian Rhythm ; Humans ; Hydrocortisone/blood ; Male ; Pituitary Neoplasms/surgery
مستخلص: We describe a very rare case of nonfunctional pituitary adenoma (NFPA) that exhibited corticotrophic activity after resection and radiotherapy. The possible mechanisms of the transformation from NFPA to Cushing disease (CD) are discussed.A 43-year-old man presented with impaired vision, bilateral frontal headaches, and hyposexuality. He had no symptoms suggestive of hypercortisolism, and 8 am plasma cortisol concentration was 67.88 ng/mL. Brain imaging revealed a 15 × 15 × 21-mm sellar mass suggestive of a macroadenoma. The tumor was resected by transsphenoidal surgery and identified by immunohistochemical analysis as a chromophobic adenoma that did not stain for pituitary hormones. The patient was treated with prednisone and levothyroxine replacement therapy. After a third recurrence, the patient presented with clinical features and physical signs of Cushing syndrome. Plasma adrenocorticotropic hormone (ACTH) and cortisol concentrations were elevated, and there was a loss of circadian rhythms. Inferior petrosal sinus sampling after desmopressin showed the central-peripheral ACTH ratio was greater than 3:1. A repeat transsphenoidal resection was undertaken. Immunohistochemistry revealed ACTH positivity. Three months following surgery, imaging showed little residual tumor, but plasma ACTH remained elevated. He was referred for postoperative Gamma Knife radiotherapy.The immunological activity and biological features of the hormones secreted from a pituitary adenoma vary with time. Because long-term outcomes are unpredictable, postoperative follow-up is essential to detect postoperative transformation from NFPA to CD.
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المشرفين على المادة: 9002-60-2 (Adrenocorticotropic Hormone)
WI4X0X7BPJ (Hydrocortisone)
تواريخ الأحداث: Date Created: 20151226 Date Completed: 20160504 Latest Revision: 20221005
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC4697967
DOI: 10.1097/MD.0000000000002134
PMID: 26705201
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5964
DOI:10.1097/MD.0000000000002134