Johnston Philip C, Hamrahian Amir H, Prayson Richard A, Kennedy Laurence, Weil Robert J
Department of Endocrinology Diabetes and Metabolism, Cleveland Clinic Foundation , 9500 Euclid Avenue Desk F20, Cleveland, Ohio, 44195 , USA.
Patholgy and Laboratory Medicine Institute, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic , Cleveland, Ohio, 44195 , USA.
Endocrinol Diabetes Metab Case Rep. 2015;2015:140070. doi: 10.1530/EDM-14-0070. Epub 2015 Jan 1.
A 54-year-old woman presented with bi-temporal hemianopia, palpitations, and diaphoresis. An invasive pituitary macroadenoma was discovered. The patient had biochemical evidence of secondary hyperthyroidism and GH excess; however, she did not appear to be acromegalic. Surgical removal of the pituitary mass revealed a plurihormonal TSH/GH co-secreting pituitary adenoma. TSH-secreting adenomas can co-secrete other hormones including GH, prolactin, and gonadotropins; conversely, co-secretion of TSH from a pituitary adenoma in acromegaly is infrequent.
This case highlights an unusual patient with a rare TSH/GH co-secreting pituitary adenoma with absence of the clinical features of acromegaly.Plurihormonality does not always translate into the clinical features of hormonal excess.There appears to be a clinical and immunohistochemical spectrum present in plurihormonal tumors.
一名54岁女性出现双颞侧偏盲、心悸和多汗。发现有侵袭性垂体大腺瘤。该患者有继发性甲状腺功能亢进和生长激素过多的生化证据；然而，她并无肢端肥大症的表现。手术切除垂体肿块显示为一种多激素性促甲状腺激素/生长激素共同分泌型垂体腺瘤。促甲状腺激素分泌型腺瘤可共同分泌其他激素，包括生长激素、催乳素和促性腺激素；相反，肢端肥大症患者垂体腺瘤中促甲状腺激素的共同分泌并不常见。
本病例突出了一名患有罕见的促甲状腺激素/生长激素共同分泌型垂体腺瘤且无肢端肥大症临床特征的特殊患者。多激素性并不总是转化为激素过多的临床特征。多激素性肿瘤似乎存在临床和免疫组化谱。
