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A Plurihormonal Adenoma:A case report Toru HATAYAMA 1 , Takashi IWABUCHI 1 , Masami ISHII 2 , Nobuhito ODA 2,3 , Atsuko ISHII 4 1Department of Neurosurgery, Hirosaki University School of Medicine 2Division of Neurosurgery, Ishii Hospital of Neurosurgery & Ophthalmology 3Division of Neurology, Ishii Hospital of Neurosurgery & Ophthalmology 4Division of Ophthalmology, Ishii Hospital of Neurosurgery & Ophthalmology Keyword: Pituitary , Plurihormonal adenoma , Prolactinoma , Growth hormone pp.755-760
Published Date 1994/8/10
DOI https://doi.org/10.11477/mf.1436900889
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A case of prolactinoma secreting growth hormone reported.

A 32-year-old woman was admitted to our hospital complaining of galactorrhea, amenorrhea and bitempo-ral hemianopsia. She showed hyperprolactinemia about 500ng/ml and elevated growth hormone level over 10ng/ml without clinical features of acromegaly. Static perimetry represented typical bitemporal hemianopsia better than kinetic perimetry in the early stage of this pituitary tumor. Her visual acuity was 1.0 on the right and 0.02 on the left. MR images showed the intra-and suprasellar mass lesion compressing the optic nerves especially on the left. Because her visual acuity deteriorated rapidly, trans-sphenoidal tumor resection was carried out twelve days after admission. Total removal was achieved. Postop-erative MRI showed that the normal pituitary gland had been preserved. The patient's visual acuity re-coverd to 1.2 on the right and 0.9 on the left, and bitemporal hemianopsia improved remarkably. Postop-erative course was uneventful and hormonal functions were normalized.

Histological examination showed that the tumor was chromophobe adnoma. The adnoma cells showed im-munopositivity for growth hormone, but not for prolac-tin. Such absence of prolactin granules within cyto-plasm might be due to the difference in antigen pro-duced by the adenomatous gland as compared with that produced by the normal gland.

Although hyperprolactinemia is often observed in acromegaly, hypersecretion of growth hormone in pro-lactinoma as was found in this case is very rare in medical literture.


Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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