Cahyanur Rahmat, Setyawan Wawan, Sudrajat Dedy G, Setyowati Susie, Purnamasari Dyah, Soewondo Pradana
Department of Internal Medicine, Faculty of Medicine, University of Indonesia-Cipto Mangunkusumo Hospital. Jl. Diponegoro no. 71, Jakarta, Indonesia.
Acta Med Indones. 2011 Apr;43(2):122-8.
Acromegaly is a rare disorder caused by excessive growth hormone. Majority of acromegaly are due to pituitary adenoma. It is estimated that 5% of pituitary adenoma become invasive and may grow to gigantic sizes (>4 cm in diameter). We would like to describe a man with giant invasive adenoma. We describe the case of 52-year-old man with acromegaly. The patient was presented to medical care because of hemichorea. He also had visual field defect, uncontrolled diabetes, and dyslipidemia. Hormonal profile showed increment of GH 2-hour after a standard 75-g oral glucose load and of high IGF-1 level with low level of FSH and LH. The next was performed by pituitary imaging. Magnetic resonance imaging showed a macroadenoma with diameter 2.3x3.5x6.6 cm3 that fills the sella tursica, and enlarges into suprasella, genu of corpus collosum, and invades third ventricle. This report describes a rare case of acromegalic patient with giant invasive adenoma. This could be a demonstrative case and lesson for diagnosis and manage acromegalic patient.
肢端肥大症是一种由生长激素过多引起的罕见疾病。大多数肢端肥大症是由垂体腺瘤所致。据估计，5%的垂体腺瘤会发展为侵袭性，且可能长到巨大尺寸（直径>4厘米）。我们想描述一位患有巨大侵袭性腺瘤的男性患者。我们描述了一名52岁患有肢端肥大症男性的病例。该患者因偏身舞蹈症就医。他还存在视野缺损、未控制的糖尿病和血脂异常。激素检查显示，在标准75克口服葡萄糖负荷后2小时生长激素升高，胰岛素样生长因子-1水平升高，促卵泡生成素和促黄体生成素水平降低。接下来进行了垂体成像检查。磁共振成像显示一个直径为2.3×3.5×6.6立方厘米的大腺瘤，占据蝶鞍，并向上延伸至鞍上、胼胝体膝部，且侵犯第三脑室。本报告描述了一例罕见的患有巨大侵袭性腺瘤的肢端肥大症患者。这可能是一个用于肢端肥大症患者诊断和管理的示范病例及经验教训。
