Prevalence of double pituitary adenomas in a surgical series: Clinical, histological and genetic features

Magri, Flavia; Villa, Chiara; Locatelli, Davide; Scagnelli, Paola; Lagonigro, Maria Stefania; Morbini, Patrizia; Castellano, Maurizio; Gabellieri, Enrico; Rotondi, Mario; Solcia, Enrico; Daly, Adrian; Chiovato, Luca

doi:10.1007/bf03346594

Cited by 30 publications

(42 citation statements)

References 34 publications

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“…Magri et al (9) reported that the incidence of double pituitary adenomas in patients who chose not to undergo surgery was 2.6%. Double or multiple pituitary adenomas, and clearly separated adenomas confirmed by preoperative imaging or intraoperative exploration in particular, are considerably rare.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients were aged 41.5-45.5 years. On the basis of preoperative, intraoperative and postoperative evaluations, 42 patients were diagnosed with clearly separated double pituitary adenomas (1-4,8,10-14,17-25), 36 patients with contiguous pituitary adenomas (6)(7)(8)(9)11,12,14,(26)(27)(28)(29), and 3 patients with 3 pituitary adenomas (11,22,23).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of double or multiple pituitary adenomas are mainly detected by one of the following methods: Imaging examination, surgical exploration or autopsy (9)(10)(11)14,16,22,23); however, the adenomas nature and type of hormones expressed are confirmed by pathology and immunohistochemistry, respectively (11). At present, in clinical practice, a useful detection method is essential to evaluate the presence of double or multiple pituitary adenomas (9).…”

Section: Discussionmentioning

confidence: 99%

“…At present, in clinical practice, a useful detection method is essential to evaluate the presence of double or multiple pituitary adenomas (9). The coexistence of multiple pituitary tumors often accounts for surgical failure (22).…”

Section: Discussionmentioning

confidence: 99%

“…The doctor making the diagnosis of double or multiple pituitary adenomas should correlate the patient's symptoms with the type of hormone produced by the tumor, since, in the majority of cases, the diagnosis of double or multiple pituitary adenomas is made only on the basis of immunohistochemical staining results. Only a few, clear cases of multiple adenomas have been confirmed by pre-and intraoperative evaluations (6,(9)(10)(11)(12). If clinicians considered the presence of ≥2 separated tumors in the same pituitary gland or the patient's clinical characteristics pre-and intraoperatively, surgical failure could be prevented to a greater extent.…”

Section: Introductionmentioning

confidence: 99%

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Isolated double adrenocorticotropic hormone-secreting pituitary adenomas: A case report and review of the literature

Wang

Zhou

et al. 2016

Oncology Letters

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Abstract. Only a few cases of double or multiple pituitary adenomas have previously been reported in the literature; however, isolated double adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are even more rare. The present study reports a rare case of a 50-year-old female patient who presented with typical clinical features of Cushing's disease and was diagnosed with isolated double ACTH-secreting pituitary adenomas. Endocrinological examination revealed an ACTH-producing pituitary adenoma, and preoperative magnetic resonance imaging (MRI) demonstrated a microadenoma with a lower intensity on the right side of the pituitary gland. The patient underwent endoscopic endonasal transsphenoidal surgery, which revealed another pituitary tumor in the left side of the pituitary gland. The two, clearly separated, pituitary adenomas identified in the same gland were completely resected. Immunohistochemistry and pathology revealed that the clearly separated double pituitary adenomas were positive for ACTH, thyroid-stimulating, growth and prolactin hormones. Postoperatively, the levels of ACTH and cortisol hormone decreased rapidly. The case reported in the present study is considerably rare, due to the presence of a second pituitary adenoma in the same gland, which was not detected by preoperative MRI scan, but was noticed during surgery. Intraoperative evaluation may be important in the identification of double or multiple pituitary adenomas.

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Section: Discussionmentioning

confidence: 99%