A Case of Macroprolactinoma with Subclinical Growth Hormone Production

Endocrine Journal

JIICHI ANZAI³  TOSHIHIRO SUDA³  YOSHIYUKI R. OSAMURA¹  KAZUNORI KAGEYAMA³  YOSHIMASA KAMATA²  TOSHIO TAKAHASHI⁴  SHIGEHARU SUZUKI⁴  TAKESHI NIGAWARA³ 

[1] Department of Pathology, Tokai University School of Medicine;Department of Pathology, Hirosaki University School of Medicine;The Third Department of Internal Medicine, Hirosaki University School of Medicine;Department of Neurosurgery, Hirosaki University School of Medicine

关键词: Prolactin;    Prolactinoma;    Growth hormone;    Acromegaly;    Insulin-like growth factor I;   

DOI  :  10.1507/endocrj.49.41

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(16)Cited-By(7)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.

【 授权许可】

Unknown