Falcone María Gabriela García, Abbati Santiago Gonzalez, Sosa Soledad, Lima Andrea Paes de, Peralta Florencia, Danilowicz Karina
División Endocrinología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina.
Departamento de Neurocirugía, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina.
Arch Endocrinol Metab. 2025 Apr 8;69(2):e240065. doi: 10.20945/2359-4292-2024-0065.
Doubleor multiple adenomas are rare, and synchronous secretory pituitary adenomas are rarer still. We report a case of a 30-year-old woman with a 6-year history of amenorrhea and occasional galactorrhoea. She presented with headaches, weight gain, subtle acromegalic features, new-onset hypertension and diabetes. Workup confirmed acromegaly and hyperprolactinemia. Preoperative magnetic resonance imaging of the pituitary demonstrated two noncontiguous microadenomas. Two distinct tumors were resected through a transsphenoidal approach. Immunohistochemical analysis of each separated adenoma confirmed the diagnosis of acromegaly and prolactinoma. Postoperatively, she was cured of acromegaly, and her amenorrhea/galactorrhea syndrome resolved. Her growth hormone and insulin-like growth factor-I levels normalized, whereas her prolactin level remained slightly above normal. Therefore, it is critical to consider double or multiple adenomas preoperatively through careful endocrine assessment and review of magnetic resonance imaging. As shown in our case, careful evaluation led to a better surgical outcome.
双腺瘤或多发腺瘤较为罕见，而同步分泌型垂体腺瘤则更为罕见。我们报告一例30岁女性，有6年闭经及偶发溢乳病史。她出现头痛、体重增加、轻微肢端肥大症特征、新发高血压和糖尿病。检查确诊为肢端肥大症和高催乳素血症。垂体术前磁共振成像显示两个不相邻的微腺瘤。通过经蝶窦入路切除了两个不同的肿瘤。对每个分离腺瘤的免疫组化分析证实了肢端肥大症和催乳素瘤的诊断。术后，她的肢端肥大症得以治愈，闭经/溢乳综合征也得到缓解。她的生长激素和胰岛素样生长因子-I水平恢复正常，而催乳素水平仍略高于正常。因此，术前通过仔细的内分泌评估和磁共振成像检查来考虑双腺瘤或多发腺瘤至关重要。如我们的病例所示，仔细评估带来了更好的手术结果。
