title: Von Hippel-Lindau disease and aggressive GH-PRL pituitary adenoma in a young boy.
abstract: Von Hippel-Lindau disease is an autosomal dominant disorder involving the development of specific tumours in multiple organs, both benign and malignant. In the CNS, the syndrome is characterized by haemangioblastomas of the retina, spinal cord and brain. We report the case of a 15-year-old boy with the diagnosis of aggressive GH-PRL pituitary macroadenoma and a family history of VHL disease. Pituitary resection was performed, although complete excision of the lesion could not be confirmed by the neurosurgeon. A control MRI was done 6 months after surgery and the pituitary lesion was similar to the presurgical image. A second operation allowed partial resection of the tumour followed by targeted radiotherapy. Pituitary adenomas are rare benign tumours in children with macroadenomas observed mainly in boys. These tumours in adolescents often occur in a familial setting or in the context of known genetic defects. Angiogenesis is an important feature of pituitary adenomas and a possible inhibitory role of pVHL in pituitary angiogenesis has been suggested. This GH-PRL pituitary macroadenoma with a VHL mutation might be of particular aggressiveness. Pituitary adenomas are not classically described in VHL syndrome and the medical community should be alerted to its rare occurrence in this location.
authors.affiliation: Unité d'endocrinologie END, Tours cedex, France. a.tudorancea@chu-tours.fr
authors.forename: Ancuta
authors.initials: A
authors.lastname: Tudorancea
authors.forename: Patrick
authors.initials: P
authors.lastname: François
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Trouillas
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Cottier
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Girard
authors.forename: Michel
authors.initials: M
authors.lastname: Jan
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gilbert-Dussardier
authors.forename: Stéphane
authors.initials: S
authors.lastname: Richard
authors.forename: Pierre
authors.initials: P
authors.lastname: Lecomte
mesh_terms: D000236:Adenoma / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000077465:Cabergoline; D004873:Ergolines / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009154:Mutation; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011388:Prolactin / Q000097:blood; D013004:Somatostatin / Q000627:therapeutic use; D016896:Treatment Outcome; D051794:Von Hippel-Lindau Tumor Suppressor Protein / Q000235:genetics*; D006623:von Hippel-Lindau Disease / Q000235:genetics*
chemical_list: D000970:Antineoplastic Agents; D004873:Ergolines; D019382:Human Growth Hormone; D013004:Somatostatin; D011388:Prolactin; D051794:Von Hippel-Lindau Tumor Suppressor Protein; C497446:VHL protein, human; D000077465:Cabergoline