Multihormonal response to CRH in a patient with Cushing syndrome and a pituitary adenoma producing ACTH and GH.
Preoperative bilateral and simultaneous catheterization of the inferior petrosal sinuses was performed in a patient with Cushing's syndrome. This procedure revealed parallel intersinus gradients for ACTH, PRL, GH and a response of all these hormones to CRH. The patient had transphenoidal surgery and a soft white-yellowish mass occupying the whole sella conditioned a total hypophysectomy. Morphologic studies and immunostaining techniques revealed a rare mixed pituitary adenoma of ACTH and GH containing cells and failed to demonstrate PRL immunoreactivity in the tumor cells. These results are of clinical and speculative interest. Whether GH and PRL secretion in response to CRH stems from the tumor or reflect hormone release by non-tumor cells via a paracrine effect remains to be defined.
Department of Endocrinology, Instituto Português de Oncologia, Lisboa.
M J
MJ
Bugalho
J F
JF
Nunes
L G
LG
Sobrinho
E
E
Medina
J A
JA
Campos
C G
CG
da Silva
A L
AL
Clode
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D002404:Catheterization; D003346:Corticotropin-Releasing Hormone; D003480:Cushing Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D007016:Hypophysectomy; D008297:Male; D016253:Microscopy, Immunoelectron; D008875:Middle Aged; D010902:Pituitary Gland / Q000378:metabolism / Q000648:ultrastructure; D010907:Pituitary Hormones / Q000378:metabolism*; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D011388:Prolactin / Q000378:metabolism; D013972:Thyrotropin / Q000378:metabolism
D010907:Pituitary Hormones; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D013972:Thyrotropin; D013006:Growth Hormone; D003346:Corticotropin-Releasing Hormone