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Coexistence of growth hormone-secreting pituitary adenoma and intracranial meningioma: A case report and review of the literature

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Abstract

The simultaneous occurrence of a pituitary adenoma and an intracranial meningioma is a rare event. We report the coexistence of an eosinophilic pituitary adenoma and a endotheliomatous meningioma, in the sellar region, and evaluate their endocrine, neuro-radiological and immunohistochemical pattern. A 47-year-old woman affected by acromegaly was referred to us. Serum GH level was 82 ng/ml and remained unresponsive to both OGTT (75 g per os) and iv. GHRH 1–29 (100 ug); IGF-1 was 807 ng/ml. Eight hours after acute sc administration of octreotide (100 ug) GH returned to normal levels (2.3 ng/ml). CT scan showed a large intra- and suprasellar mass involving the right cavernous sinus, with a retrosellar extension along the tentorium. A slight and inhomogeneous enhancement, with a periferal rim of bright signal was apparent at MRI. Conversely, the retrosellar component showed a bright homogeneous enhancement. The patient, therefore, underwent neurosurgery. Histological examination revealed the coexistence of 2 types of tissue: areas of endotheliomatous meningioma were interspersed among sheets of acidophilic adenoma tissue. Immunohistochemical analysis was performed in order to determine the relationship between the two masses: a positive staining for GH was shown in the areas of adenoma, as against for GHRH, neither in the adenomatous tissue nor in the slices of meningioma. Although MRI showed a latero-sellar post-surgical residual of meningioma, serum GH value was <1 ng/ml. In conclusion, the relationship beetwen the GH-secreting adenoma and the meningioma is unclear; however the GH-hypersecretion is not induced by a hypothetic GHRH-activity from the meningioma.

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Authors and Affiliations

  1. Cattedra di Endocrinologia, Università di Messina, Messina, Italy

    S. Cannavò, L. Curtò, R. Fazio & F. Trimarchi

  2. Istituto di Scienze Neurologiche e Neurochirurgiche, Divisione di Neurochirurgia, Università di Messina, Messina, Italy

    S. Paterniti

  3. Istituto di Oncologia, Università di Messina, Messina, Italy

    A. Blandino

  4. Dipartimento di Patologia Umana, Università di Messina, Messina, Italy

    T. Marafioti

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  1. S. Cannavò
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  2. L. Curtò
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Cannavò, S., Curtò, L., Fazio, R. et al. Coexistence of growth hormone-secreting pituitary adenoma and intracranial meningioma: A case report and review of the literature. J Endocrinol Invest 16, 703–708 (1993). https://doi.org/10.1007/BF03348915

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