title: Growth hormone-secreting pituitary adenoma associated with primary moyamoya disease--case report.
abstract: A 40-year-old female presented with growth hormone (GH)-secreting pituitary adenoma associated with primary moyamoya disease manifesting as amenorrhea, acromegaly, and transient ischemic attack. Magnetic resonance (MR) imaging revealed a tumor mass extending from the sella turcica to the suprasellar cistern, and MR angiography demonstrated stenoses in the bilateral internal carotid arteries with basal moyamoya vessels. Her blood GH and insulin-like growth factor (IGF-1) levels were elevated to 78.94 and 923.0 ng/ml, respectively. The patient underwent removal of the pituitary adenoma because her ischemic symptoms disappeared after oral aspirin medication. Subtotal resection resulted in persistence of the high blood GH and IGF-1 levels. Postoperative MR angiography showed progression of the stenoses in the bilateral internal carotid arteries. Excess systemic GH and IGF-1 may participate in the progression of vascular disease and so could have caused the deterioration of the moyamoya disease.
authors.affiliation: Department of Neurosurgery, Shimizu Hospital, Kyoto, Japan. ciao-ns4@ares.eonet.ne.jp
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Uchida
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohyama
authors.forename: Manabu
authors.initials: M
authors.lastname: Sirakawa
authors.forename: Rie
authors.initials: R
authors.lastname: Tsuji
authors.forename: Masao
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Imataka
authors.forename: Manabu
authors.initials: M
authors.lastname: Sato
authors.forename: Yukio
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000378:metabolism*; D000328:Adult; D004569:Electroencephalography; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D018810:Magnetic Resonance Angiography; D009072:Moyamoya Disease / Q000150:complications* / Q000473:pathology; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000150:complications* / Q000378:metabolism*; D012658:Sella Turcica / Q000473:pathology
chemical_list: D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone