Document Detail

A case of macroprolactinoma with subclinical growth hormone production.
MedLine Citation:
PMID:  12008749     Owner:  NLM     Status:  MEDLINE    
We describe a rare case of macroprolactinoma with subclinically synchronous growth hormone (GH) production. A 59-year-old man with a giant adenoma in his pituitary had elevated serum prolactin (PRL) and insulin-like growth factor (IGF)-I levels, despite normal levels of basal GH. Serum GH levels were paradoxically increased in response to an intravenous administration of thyrotropin-releasing hormone (TRH). Prolonged exposure to glucose as a result of oral glucose tolerance testing (oGTT) failed to decrease GH levels. Two-week treatment with cabergoline, a dopamine D2 receptor agonist, decreased serum PRL and GH levels, and size of the tumor. Immunohistochemistry and in situ hybridization revealed PRL-producing cells capable of synchronous GH production. Acidophilic stem cell adenoma may be responsible for these phenomena. The nature of high proliferation and invasive tumor growth should be kept in mind when managing patients with this cell type of adenoma. IGF-I levels should be followed in PRLoma, even when basal GH levels are within the normal range, because mixed PRL- and GH-producing tumors would lie underneath. Further endocrinological examinations such as TRH test and oGTT are recommended when elevated IGF-I levels are detected.
Kazunori Kageyama; Takeshi Nigawara; Yoshimasa Kamata; Toshio Takahashi; Jiichi Anzai; Shigeharu Suzuki; Yoshiyuki R Osamura; Toshihiro Suda
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endocrine journal     Volume:  49     ISSN:  0918-8959     ISO Abbreviation:  Endocr. J.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-05-14     Completed Date:  2002-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
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MeSH Terms
Adrenocorticotropic Hormone / biosynthesis
Dexamethasone / administration & dosage
Glucocorticoids / administration & dosage
Human Growth Hormone / biosynthesis*,  blood,  genetics
Hydrocortisone / biosynthesis
In Situ Hybridization
Insulin-Like Growth Factor I / analysis,  metabolism
Middle Aged
Prolactin / blood,  genetics,  metabolism
Prolactinoma / metabolism*,  pathology
Reg. No./Substance:
0/Glucocorticoids; 12629-01-5/Human Growth Hormone; 50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 67763-96-6/Insulin-Like Growth Factor I; 9002-60-2/Adrenocorticotropic Hormone; 9002-62-4/Prolactin

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