Radner H, Pummer K, Lax S, Wandschneider G, Höfler H
Institute of Pathology, University of Graz, School of Medicine, Austria.
Neuropathol Appl Neurobiol. 1991 Feb;17(1):75-81. doi: 10.1111/j.1365-2990.1991.tb00696.x.
A 78-year-old male was treated with goserelin (Zoladex) for 16 months for metastasizing prostate carcinoma. This therapy is clinically equivalent to orchidectomy, as the application of the luteinizing hormone-releasing hormone (LHRH)-analogue Zoladex causes suppression of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by down-regulation of pituitary receptors. Consequently, testicular androgen production is inhibited and testosterone levels are decreased to castration levels. In the present case we found diffuse, partially nodular hyperplasia of growth hormone (GH) and adrenocorticotropin (ACTH) producing cells in the anterior pituitary gland at autopsy. As Zoladex reduces pituitary receptors for releasing hormones (RH), a globally increased hypothalamic secretion of RH might be responsible for the ACTH- and the GH-cell hyperplasia. We cannot exclude that Zoladex may cause not only adenomas in rat pituitary glands as reported previously, but also a (nodular) hyperplasia of the pituitary gland in man.
一名78岁男性因转移性前列腺癌接受戈舍瑞林（Zoladex）治疗16个月。这种治疗在临床上等同于睾丸切除术，因为黄体生成素释放激素（LHRH）类似物Zoladex的应用通过下调垂体受体来抑制促卵泡激素（FSH）和黄体生成素（LH）。因此，睾丸雄激素生成受到抑制，睾酮水平降至去势水平。在本病例中，尸检时我们发现垂体前叶中生长激素（GH）和促肾上腺皮质激素（ACTH）分泌细胞呈弥漫性、部分结节性增生。由于Zoladex减少了垂体释放激素（RH）受体，下丘脑RH分泌的整体增加可能是ACTH和GH细胞增生的原因。我们不能排除Zoladex不仅如先前报道的那样可导致大鼠垂体腺瘤，还可能导致人类垂体（结节性）增生。
