CASE REPORT

A Case of Plurihormonal Pituitary Giant Macroadenoma
Plurihormonal Hipofizer Dev Makroadenomu Olan Olgu Sunumu
Received Date : 15 Sep 2020
Accepted Date : 31 Dec 2020
Available Online : 23 Mar 2021
Doi: 10.25179/tjem.2020-78997 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:227-231
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
We would like to draw the attention of the readers to Pit-1 positive giant macroadenomas in this work. A 62-year-old male patient was admitted to the hospital due to his vision loss and blurred vision in the left eye. His pituitary magnetic resonance imaging revealed the presence of a diffuse and homogeneous mass lesion originating from the pituitary gland having grade 4 invasion into the bilateral cavernous sinus and eroding the base of the sella. He consulted our department before his operation in 2016. Laboratory examination revealed that pituitary hormone levels were within normal ranges while the testosterone level [total testosterone 0.27 ng/mL (2.8-8)] was low. Pathological findings revealed a pituitary adenoma that displayed focal immunoreactivity to thyrotrophin, growth hormone, and prolactin. While the main prevalence and the basic mechanism of plurihormonal pituitary adenomas are not clear, one of the hypotheses is based on the role of divergent transcription factors such as Pit-1. According to this condition, we should perform a complete biochemical and histologic evaluation in patients with pituitary adenomas.
ÖZET
Bu çalışmada, Pit-1 pozitif dev makroadenomlara dikkat çekmek istedik. Altmış iki yaşında erkek hasta, sol gözde görmede azalma ve bulanık görme nedeniyle hastaneye başvurdu. Hipofiz manyetik rezonans görüntülemesinde, hipofiz bezinden kaynaklanan yaygın homojen kitle lezyonunun, bilateral kavernöz sinüse 4. derece invazyonunun olduğu ve sella tabanını aşındırdığı izlendi. Preoperatif dönemde, endokrinoloji bölümümüze konsülte edilmişti. Laboratuvar incelemesinde hipofiz hormon düzeyleri normal sınırlarda, total testosteron düzeyi 0,27 ng/mL (2,8-8) düşüktü. Operasyon sonrası patoloji sonucu, fokal tirotropin, büyüme hormonu ve prolaktin immünoreaktivitesi gösteren bir hipofiz adenoma olarak raporlandı. Plurihormonal hipofiz adenomlarının prevalansı ve temel mekanizması net değildir; hipotezlerden biri, Pit-1 gibi farklı transkripsiyon faktörlerinin rolüne bağlı olabileceği yönündedir. Hipofiz adenomlu hastalarda, tam bir biyokimyasal ve histolojik değerlendirme yapmalıyız.
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