A 53-yr-old man with Cushing's disease was found to have a pituitary carcinoma with metastases to the liver and lung which produced both CRH and ACTH simultaneously. Despite removal of the pituitary tumor, his Cushing's disease worsened. Endocrinological examination then demonstrated elevated plasma CRH and markedly elevated plasma ACTH, beta-lipotropin, and cortisol concentrations, increased urinary 17-hydroxycorticosteroid and 17-ketosteroid excretion, and no suppression of serum cortisol after low or high dose dexamethasone administration. Urinary 17-hydroxycorticosteroid excretion increased in response to metyrapone, and lysine vasopressin elicited a striking increase in plasma ACTH. A computed tomographic scan of abdomen revealed multiple hypodense areas in the liver and bilateral adrenal hyperplasia. Postmortem histological examination revealed a necrotic hemorrhagic pituitary carcinoma with metastases to the liver, lung, and olfactory bulb. Immunohistochemical staining, gel filtration, and Northern blot analysis of liver and lung metastases revealed evidence of the production of both CRH and ACTH in these metastases. We concluded that the patient's pituitary carcinoma produced both CRH and ACTH.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1210/jcem-71-4-1068 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endoscopic endonasal approach for pituitary neuroendocrine tumor with septal mucosa incision tailored to tumor extension intending unilateral septal mucosa preservation.
Sci Rep
January 2025
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Currently, the direct endonasal approach is widely used in endoscopic endonasal surgery (EES) for pituitary neuroendocrine tumor. However, a large posterior septal perforation is inevitable. We routinely utilize a modified para/transseptal approach using the combination of a Killian and a contralateral rescue flap incision (PTSA with K-R incision).
View Article and Find Full Text PDFThis study aimed to develop and validate machine learning (ML) models to predict the occurrence of delayed hyponatremia after transsphenoidal surgery for pituitary adenoma. We retrospectively collected clinical data on patients with pituitary adenomas treated with transsphenoidal surgery between January 2010 and December 2020. From January 2021 to December 2022, patients with pituitary adenomas were prospectively enrolled.
View Article and Find Full Text PDFDeveloping Topics.
Alzheimers Dement
December 2024
Cairo University Faculty of Medicine, Cairo, Cairo, Egypt.
Background: Although most pituitary tumors are benign, functioning pituitary tumors are dangerous as they produce and deteriorate the endocrine hormones. Prolactinomas are one of these tumors that arise from lactotroph cells of the anterior pituitary, and they're about 40% of all pituitary adenomas. They secrete high levels of prolactin, which are normally inhibited by dopamine.
View Article and Find Full Text PDFKnosp and revised Knosp classifications predict non-functioning pituitary adenoma outcomes: a single tertiary center experience.
J Med Life
November 2024
Department of Endocrinology, Diabetology and Nutrition, Mohammed VI University Hospital, Medical School, Mohamed the First University, Oujda, Morocco.
Non-functioning pituitary adenomas (NFPAs) are hormonally inactive benign tumors, usually diagnosed as macro-adenoma. The aim of our research was to analyze the clinical and hormonal characteristics of NFPAs using Knosp and revised Knosp classifications. Furthermore, we aimed to assess the possibility of predicting surgical remission after surgery.
View Article and Find Full Text PDFEndocrine dysfunction in long-term survivors of pediatric head and neck rhabdomyosarcoma.
Eur J Endocrinol
January 2025
Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.
Objective: Survivors of pediatric head and neck rhabdomyosarcoma (HNRMS) are at risk of developing endocrinopathies following local treatment, resulting from radiation damage to the pituitary gland, hypothalamus, or thyroid gland, often at a young age. Our aim was to determine the prevalence of endocrine dysfunction in long-term HNRMS survivors and compare the prevalence of anterior pituitary insufficiency (API) among different local treatment strategies: external beam radiation with photons, external beam radiation with protons, microscopically radical surgery combined with external irradiation, and macroscopic radical surgery combined with brachytherapy.
Design And Methods: Head and neck rhabdomyosarcoma survivors treated between 1993 and 2017, with ≥2 years of follow-up, without recurrent disease or secondary malignancy were eligible for this study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!