Kurtulmus N, Kayikci K, Yarman S
Maslak Hospital of Acibadem Medical Faculty, Endocrinology Clinic, Acibadem University, Istanbul, Türkiye.
Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Türkiye.
Acta Endocrinol (Buchar). 2024 Jul-Sep;20(3):403-407. doi: 10.4183/aeb.2024.403. Epub 2025 May 23.
Carpal tunnel syndrome(CTS) is a neuropathy of the upper limb that is quite common in patients with active acromegaly, but the diagnosis of acromegaly is often made years after the diagnosis of CTS. But in the absence of the typical acral phenotype it is difficult to know when CTS will appear as the first symptom.
Here, we present a 27-year-old female patient with a history of numbness that first appeared in her right hand and 2 weeks later in her left hand. While the etiology of acute CTS was being investigated on cervical MRI, the hormonal evaluation of the incidentally detected mass in the sella turcica revealed that it was a clinically silent somatotroph adenoma.
Considering the patient's age, desire to have children, lack of typical acral features, the fact that these adenomas may cause phenotypic changes over time, their aggressive course and more recurrences, the decision for transsphenoidal surgery was made. The patient, who has been followed for 14 years, has two healthy children and does not have any complaints, acral phenotype or GH hormone excess.
Awareness that acute unilateral/bilateral CTS without any risk factors may be the first sign of clinically silent somatotrophinoma may improve the prognosis of acromegaly by preventing diagnostic delay.
腕管综合征（CTS）是一种上肢神经病变，在活动性肢端肥大症患者中相当常见，但肢端肥大症的诊断往往在CTS诊断数年之后才做出。但在缺乏典型肢端表型的情况下，很难知道CTS何时会作为首发症状出现。
在此，我们报告一名27岁女性患者，其最初右手出现麻木，2周后左手也出现麻木。在通过颈椎MRI调查急性CTS的病因时，对蝶鞍内偶然发现的肿块进行的激素评估显示，这是一个临床无症状的生长激素腺瘤。
考虑到患者的年龄、生育愿望、缺乏典型肢端特征、这些腺瘤可能随时间引起表型变化、其侵袭性病程和更多复发情况，决定进行经蝶窦手术。该患者已随访14年，育有两个健康孩子，无任何不适、肢端表型或生长激素过量情况。
认识到无任何危险因素的急性单侧/双侧CTS可能是临床无症状生长激素瘤的首发体征，可能通过防止诊断延迟来改善肢端肥大症的预后。
