title: Secretion of high-molecular-weight adrenocorticotropic hormone from a pituitary adenoma in a patient without Cushing stigmata. Case report.
abstract: The authors report a case in which a patient harbored a corticotroph macroadenoma that secreted biologically inactive high-molecular-weight adrenocorticotropic hormone (ACTH) as well as authentic ACTH 1-39. The secretion of the high-molecular-weight ACTH was determined using gel chromatography. The authors believe that these two molecules competed with each other at the ACTH receptor and, thus, the bioactivity of ACTH 1-39 was masked and Cushing features were not manifested in the patient. This type of silent corticotroph adenoma may be categorized as a clinically nonfunctioning adenoma. Plasmas from patients with silent corticotroph adenomas, which are identified by positive immunohistochemical staining of ACTH, should be frozen, stored, and analyzed using gel chromatography to examine whether the tumors produce and secrete high-molecular-weight ACTH.
authors.affiliation: Department of Neurosurgery, Teikyo University Ichihara Hospital, Ichihara City, Chiba, Japan. akirakun@med.teikyo-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuno
authors.forename: Ryo
authors.initials: R
authors.lastname: Okazaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagashima
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000737:chemistry / Q000378:metabolism*; D000328:Adult; D006801:Humans; D008297:Male; D008970:Molecular Weight; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery
chemical_list: D000324:Adrenocorticotropic Hormone