Plurihormonal Adenomas

Labadzhyan, Artak; Melmed, Shlomo

doi:10.1007/978-3-030-11836-5_12

Cited by 2 publications

(1 citation statement)

References 68 publications

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“…Пролактиномы -наиболее часто встречающиеся аденомы гипофиза, составляют около 40% всех гормонально-активных опухолей аденогипофиза, из них 80% представлены микроаденомами (до 10 мм в диаметре), 15% -макроаденомами (более 10 мм в диаметре) и 5% -гигантскими аденомами (более 4-6 см) [3]. Второе по частоте встречаемости место после пролактином в 20-25% случаев занимают опухоли гипофиза, секретирующие гормон роста (ГР) [4]. Среди них соматотропиномы с автономной гиперсекрецией составляют примерно 17% всех опухолей гипофиза и являются моноклональными образованиями, возникающими в результате соматической мутации рецептора Gsp-белка (Gsp-онкогена).…”

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Features of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical case

Morugova,

Avzaletdinova,

Morugova

2023

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A patient aged 32 with complaints of primary infertility based on additional examination data (increased blood prolactin level, presence of pituitary gland formation according to magnetic resonance imaging of the brain) was diagnosed with prolactin-secreting pituitary microadenoma. At the same time, galactorrhea and menstrual disorders were not noted. Against the background of cabergoline treatment, a pregnancy occurred, which ended with the birth of a full-term healthy child. After delivery, the patient resumed dosing cabergoline 0.5 mg 1 once every two weeks, against the background of which a pronounced decrease in prolactin levels was observed, but there was a progression in the growth of pituitary adenoma (macroadenoma). No acromegaly traits were observed in the patient.Against the background of withdrawal of cabergoline, the patient underwent a study of tropical pituitary hormones, which revealed an increase in the level of growth hormone and insulin-like growth factor-1. During the oral glucose tolerance test with 75 grams of glucose, the somatotropin-producing activity of the pituitary macroadenoma was confirmed. At the age of 43, the patient underwent transsphenoidal adenomectomy, after which she experienced persistent remission for past 6 years.The purpose of this work is to focus the attention of practitioners on the manifestation of possible mixed hormonal activity of pituitary microadenomas.

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Features of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical case

Morugova,

Avzaletdinova,

Morugova

2023

jour

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Difficulties in diagnosis of adenomas with mixed prolactin and growth hormone secretion: case presentation

et al. 2020

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Hyperpolactinemia is a persistent excess of prolactin in the blood serum. The symptom complex of hyperprolactinemia primarily consists of disturbances in function of the reproductive system. The secretion of prolactin is under complex neuroendocrine control, which involves factors of different nature: neurotransmitters, hormones of the peripheral endocrine glands. In most cases, prolactin is secreted by pituitary cells - lactotrophs, but in some cases, hypersecretion of prolactin is combined with an excess production of growth hormone, which is typical for tumors originating from the line of progenitor cells of lactotrophs and somatotrophs of the pituitary gland, mammosomatotrophs. In this case, the symptom complex of hyperprolactinemia is accompanied by clinical manifestations of acromegaly. In patients with acromegaly, the cause of hyperprolactinemia may be pituitary stalk compression or mixed secretion of prolactin and growth hormone. Differentiation of lactotropic and somatotropic pituitary cells is determined by transcription factor Pit-1. These cell lineages are closely connected, and this may be one of the reasons for formation of tumors with mixed secretion. Reports of late presentation of acromegaly in patients previously diagnosed with prolactinomas have also been described in literature.Clinical manifestations of hyperprolactinemia can cause the patient to seek doctor’s attention before acromegalic changes in appearance develop. Careful attention is needed both to the primary diagnosis and to the clinical course of the disease in patients with hyperprolactinemia and pituitary adenoma: full assessment of hormonal status with mandatory evaluation of IGF-1 is crucial at initial examination, during further observation it may be advised to consider periodic evaluation of IGF-1 in addition to assessment of prolactin and the size of adenoma. Pituitary adenomas with mixed secretion may have a poorer prognosis.

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Plurihormonal Adenomas

Cited by 2 publications

References 68 publications

Features of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical case

Features of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical case

Difficulties in diagnosis of adenomas with mixed prolactin and growth hormone secretion: case presentation

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