title: Double, synchronous pituitary adenomas causing acromegaly and Cushing's disease. A case report and review of literature.
abstract: Double pituitary adenomas are very rare and present up to 1 % of pituitary adenomas in unselected autopsy series and up to 2 % in large surgical series. We report a case of a 47-year-old man presented slight clinical features of acromegaly with 2 years duration. Endocrine evaluation confirmed active acromegaly and revealed adrenocorticotropin hormone-dependent hypercortisolemia. Preoperative magnetic resonance imaging of the pituitary demonstrated clearly separated double microadenomas with different intensity. The patient underwent transsphenoidal surgery and both tumors were completely removed and were fixed separately. The histological and ultrastructural examination confirmed coincidence of the double, clearly separated pituitary adenomas in one gland. Postoperative function of the hypothalamo-hypophyseal axis was normalized. We conclude from this case and a literature review that double endocrinologically active pituitary adenomas leading to acromegaly and Cushing's disease may occur. Additionally, a review of the literature regarding multiple pituitary adenomas has also been performed.
authors.affiliation: Department of Neurosurgery, Military Institute of Medicine, 128 Szaserów Street., 04-141 Warszawa 44, Warsaw, Poland. gzielinski@wim.mil.pl
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zieliński
authors.forename: Maria
authors.initials: M
authors.lastname: Maksymowicz
authors.forename: Jan
authors.initials: J
authors.lastname: Podgórski
authors.forename: Włodzimierz T
authors.initials: WT
authors.lastname: Olszewski
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000236:Adenoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D047748:Pituitary ACTH Hypersecretion / Q000150:complications / Q000473:pathology* / Q000601:surgery; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome