Endocrinol Metab > Volume 21(1); 2006 > Article
Journal of Korean Endocrine Society 2006;21(1):53-57.
DOI: https://doi.org/10.3803/jkes.2006.21.1.53    Published online February 1, 2006.
A Case of Acromegaly Caused by Double Pituitary Adenomas.
Hai Jin Kim, Chul Sik Kim, Jong Suk Park, Jina Park, Jee Hyun Kong, Ji Sun Nam, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Soon Won Hong
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2Department of pathology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
Acromegaly is a clinical syndrome, which is caused by an excess of growth hormone (GH), most commonly secreted from a pituitary solitary adenoma. However, our patient had bilateral GH-secreting pituitary tumors, the incidence of which has been reported in only 1.3 to 1.69% of all acromegalic patients. A 59-year-old female, with no family history of pituitary adenomas, demonstrated an increased level of serum insulin-like growth factor-1 (IGF-1), and GH not suppressed after 75 g oral glucose loading. On a preoperative MRI, only one pituitary tumor, measuring 1.1 x 0.7 cm, could be observed using sellar MRI. After surgical resection of the tumor, her headache and myalgia were sustained, and the IGF-1 level was still in a high titer. Therefore, a follow-up sellar MRI was taken, and a 0.6 x 0.7 cm sized newly growing pituitary tumor was found on the other side. With a retrospective review of radiological examinations, the patient was found to have bilateral tumors. The 0.3 cm sized tumor on the left was too small to be detected on the preoperative MRI. As the patient preferred medical treatment after surgery, she was treated with sandostatin analogues. Acromegaly with bilateral GH-secreting pituitary tumors, is a very rare disease, with no previous case having been reported in Korea. Herein, we report the case with a review of the literature.
Key Words: Double pituitary adenomas, Acromegaly, IGF-1, Multiple pituitary tumors


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