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Acidophil stem cell pituitary adenoma: a case report and literature review

  • Anupriya AnnapurniEmail author
  • Manjusha Rathi
Case Report
  • 15 Downloads

Abstract

In this article, we describe a very rare case of pituitary acidophilic stem cell adenoma, accompanied by a literature review. We present the case of 33-year-old woman with a history of amenorrhea, galactorrhea, elevated prolactin levels, and pituitary tumor. Despite suppression of prolactin levels with cabergoline, the pituitary tumor continued to increase in size and the patient developed clinical symptoms and biochemistry consistent with the diagnosis of acromegaly due to acidophilic stem cell adenoma, an extremely rare subtype of mixed growth hormone/prolactin adenoma, which behaves more aggressively and has a lower surgical cure rate compared to the pure GH-secreting adenoma. The patient had in vitro fertilization 2 years after the successful pituitary surgery and delivered healthy twins. To our knowledge, this is the only case report which describes acromegaly developing during cabergoline treatment. This case also highlights the importance of having a correct histopathological diagnosis to determine the behavior of the tumor and decide on further management.

Keywords

Acidophilic Pituitary adenoma Acromegaly Pituitary stem cell adenoma 

Abbreviations

IVF

In vitro fertilization

IGF1

Insulin growth factor 1

OGTT

Oral glucose tolerance test

GH

Growth hormone

PRL

Prolactin

MRI

Magnetic resonance imaging

FSH

Follicular stimulating hormone

LH

Luteinizing hormone

SHBG

Serum hormone-binding globulin

TSH

Thyroid-stimulating hormone

FT4

Free thyroxine

FT3

Free tri-iodothyronine

ACTH

Adrenocorticotrophic stimulating hormone

HbA1c

Hemoglobin A1c

mm

Millimeter

pmol

Picomol

mu/L

Micro units/liter

U/L

Units/liter

nmol/L

Nanomols/liter

mcg/L

Microgram/liter

mmol/L

Millimol/liter

AMAU

Acute medical admission unit

Notes

Contributorship

Both Anupriya Annapurni and Manjusha Rathi contributed to the planning of the manuscript, the review of the literature, and the writing and review of the original and final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no potential conflicts of interest.

Statement of informed consent

Informed consent has been obtained from the patient for publication of the case report and accompanying images.

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Copyright information

© Hellenic Endocrine Society 2019

Authors and Affiliations

  1. 1.Department of Diabetes and Endocrinology, Queen’s Medical CentreNottingham University Hospitals NHS TrustNottinghamUK
  2. 2.Department of Diabetes and EndocrinologyKing’s Mill Hospital, Sherwood Forest Hospitals NHS Foundation TrustNottinghamshireUK

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