Document Detail


Case report: acromegaly and Cushing's disease in a patient with synchronous pituitary adenomas.
MedLine Citation:
PMID:  1442869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 40-year-old white woman presented with hirsutism, amenorrhea, generalized fatigue, diffuse weight gain, acral changes, and coarsened facial features. Physical examination revealed mild diastolic hypertension, acromegalic features, hirsutism, and seborrhea. The growth hormone concentration was elevated and did not suppress after glucose administration. Urinary free cortisol excretion was increased and was not suppressed during a 2 mg low-dose dexamethasone suppression test. Magnetic resonance imaging of the sella demonstrated a 1.3 x 1.2 x 0.8 cm pituitary adenoma. Trans-sphenoidal resection was performed, and portions of the resected tumor were analyzed by routine pathologic methods. Histopathologic and immunohistochemical findings indicated discrete growth hormone- and adrenocorticotropic hormone-producing pituitary adenomas. Coexisting acromegaly and Cushing's syndrome due to pituitary neoplasia was previously reported in two patients. However, to the authors' knowledge, this represents the first description of a patient with acromegaly and Cushing's disease resulting from discrete synchronous adenomas of the pituitary gland as defined by modern histopathologic techniques.
Authors:
L S Blevins; G S Hall; D H Madoff; E R Laws; G S Wand
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  304     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-04     Completed Date:  1992-12-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  294-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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MeSH Terms
Descriptor/Qualifier:
17-Ketosteroids / urine
Acromegaly / blood,  etiology*,  urine
Adenoma / blood,  diagnosis*,  surgery,  urine
Adult
Cushing Syndrome / blood,  etiology*,  urine
Dehydroepiandrosterone / analogs & derivatives,  blood
Dehydroepiandrosterone Sulfate
Dexamethasone / diagnostic use
Female
Hirsutism / blood,  etiology,  urine
Humans
Hydrocortisone / urine
Magnetic Resonance Imaging
Pituitary Neoplasms / blood,  diagnosis*,  surgery,  urine
Reference Values
Testosterone / blood
Grant Support
ID/Acronym/Agency:
DK-01298/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/17-Ketosteroids; 50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 53-43-0/Dehydroepiandrosterone; 58-22-0/Testosterone; 651-48-9/Dehydroepiandrosterone Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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