title: Gigantism associated with a pituitary tumour secreting growth hormone and prolactin and cured by transsphenoidal hypophysectomy.
abstract: An 18-year old male is reported who presented with a history of a growtn spurt over the year preceding his admission. His height was above the 97th percentile, and he had incompletely developed secondary sexual characters. Pituitary evaluation demonstrated a moderately elevated level of growth hormone (hGH) not suppressible by a glucose load and not stimulable by TRH or by L-DOPA. Serum prolactin (PRL) concentration was also increased while gonadotrophin, thyroid and adrenal function were all subnormal. There was clear radiological evidence of a large pituitary tumour with suprasellar extension and transsphenoidal total hypophysectomy was performed. A mixed chromophobe and acidophilic adenoma was found and both growth hormone and prolactin were demonstrable in different cells of the tumour by the immunoperoxidase technique. Post-operatively the patient has hypopituitarism and levels of growth hormone and prolactin have remained low or undetectable after 6 months. Thus early diagnosis and surgical treatment of gigantism of this mixed hGH-PRL secreting pituitary tumour was associated with a cure, which contrasts with the unfavourable outcome of many of the patients previously reported.
mesh_terms: D000239:Adenoma, Acidophil / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D000238:Adenoma, Chromophobe / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D000293:Adolescent; D005877:Gigantism / Q000209:etiology*; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D007016:Hypophysectomy; D008297:Male; D010911:Pituitary Neoplasms / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D011388:Prolactin / Q000378:metabolism*
chemical_list: D011388:Prolactin; D013006:Growth Hormone