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Article: Pituitary stone: Two cases of densely calcified thyrotrophin-secreting pituitary adenomas

TitlePituitary stone: Two cases of densely calcified thyrotrophin-secreting pituitary adenomas
Authors
Issue Date1994
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0300-0664
Citation
Clinical Endocrinology, 1994, v. 40 n. 1, p. 137-143 How to Cite?
AbstractCalcification is a well recognized but relatively uncommon feature of prolactin-secreting, growth hormone-secreting and non-functional pituitary tumours. It varies in extent, but rarely exceeds a tiny amount histologically or radiologically. Thyrotroph adenomas are the rarest of the secretory pituitary tumours, accounting for less than 1% of cases, and partial calcification of such lesions has been reported in only three cases. We describe two patients in whom the clinical and biochemical features indicated the presence of a TSH-secreting adenoma and radiology demonstrated a large 'pituitary stone'. One patient, a 59-year-old female, initially presented with hyperthyroidism, aged 18, and was rendered euthyroid by two subtotal thyroidectomies before a pituitary lesion was suspected, over 20 years later. Autonomous secretion of thyrotrophin was demonstrated by dynamic tests, and the failure of exogenous T3 to reduce the serum TSH. In the absence of tumour expansion and compressive symptoms, pituitary surgery was not undertaken. At the age of 56, she developed symptoms of intermittent ataxia and diplopia, culminating in a focal seizure, and was found on CT scan to have, in addition to the pituitary lesion, a parasagittal meningioma. This was successfully removed at craniotomy. In the second patient, a 42-year-old male, the finding of hyperthyroidism in association with an elevated TSH concentration led to the discovery of a pituitary stone which was removed transethmoidally, together with surrounding adenomatous tissue which stained positively for TSH on immunocytochemistry. We suggest that calcific changes may be at least as common in TSH-secreting tumours as in other pituitary adenoma subtypes and may occur to the extent of 'pituitary stone' formation. The possible association between meningiomas and pituitary adenomas is discussed.
Persistent Identifierhttp://hdl.handle.net/10722/162045
ISSN
2015 Impact Factor: 3.487
2015 SCImago Journal Rankings: 1.314
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWebster, Jen_US
dc.contributor.authorPeters, JRen_US
dc.contributor.authorJohn, Ren_US
dc.contributor.authorSmith, Jen_US
dc.contributor.authorChan, Ven_US
dc.contributor.authorHall, Ren_US
dc.contributor.authorScanlon, MFen_US
dc.date.accessioned2012-09-05T05:16:52Z-
dc.date.available2012-09-05T05:16:52Z-
dc.date.issued1994en_US
dc.identifier.citationClinical Endocrinology, 1994, v. 40 n. 1, p. 137-143en_US
dc.identifier.issn0300-0664en_US
dc.identifier.urihttp://hdl.handle.net/10722/162045-
dc.description.abstractCalcification is a well recognized but relatively uncommon feature of prolactin-secreting, growth hormone-secreting and non-functional pituitary tumours. It varies in extent, but rarely exceeds a tiny amount histologically or radiologically. Thyrotroph adenomas are the rarest of the secretory pituitary tumours, accounting for less than 1% of cases, and partial calcification of such lesions has been reported in only three cases. We describe two patients in whom the clinical and biochemical features indicated the presence of a TSH-secreting adenoma and radiology demonstrated a large 'pituitary stone'. One patient, a 59-year-old female, initially presented with hyperthyroidism, aged 18, and was rendered euthyroid by two subtotal thyroidectomies before a pituitary lesion was suspected, over 20 years later. Autonomous secretion of thyrotrophin was demonstrated by dynamic tests, and the failure of exogenous T3 to reduce the serum TSH. In the absence of tumour expansion and compressive symptoms, pituitary surgery was not undertaken. At the age of 56, she developed symptoms of intermittent ataxia and diplopia, culminating in a focal seizure, and was found on CT scan to have, in addition to the pituitary lesion, a parasagittal meningioma. This was successfully removed at craniotomy. In the second patient, a 42-year-old male, the finding of hyperthyroidism in association with an elevated TSH concentration led to the discovery of a pituitary stone which was removed transethmoidally, together with surrounding adenomatous tissue which stained positively for TSH on immunocytochemistry. We suggest that calcific changes may be at least as common in TSH-secreting tumours as in other pituitary adenoma subtypes and may occur to the extent of 'pituitary stone' formation. The possible association between meningiomas and pituitary adenomas is discussed.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0300-0664en_US
dc.relation.ispartofClinical Endocrinologyen_US
dc.rightsClinical Endocrinology. Copyright © Blackwell Publishing Ltd.-
dc.subject.meshAdenoma - Complications - Radiography - Secretionen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshCalcinosis - Complications - Radiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHyperthyroidism - Etiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMeningeal Neoplasms - Complicationsen_US
dc.subject.meshMeningioma - Complicationsen_US
dc.subject.meshPituitary Diseases - Complications - Radiographyen_US
dc.subject.meshPituitary Gland - Radiographyen_US
dc.subject.meshPituitary Neoplasms - Complications - Secretionen_US
dc.subject.meshThyrotropin - Secretionen_US
dc.subject.meshThyroxine - Blooden_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.subject.meshTriiodothyronine - Blooden_US
dc.titlePituitary stone: Two cases of densely calcified thyrotrophin-secreting pituitary adenomasen_US
dc.typeArticleen_US
dc.identifier.emailChan, V:vnychana@hkucc.hku.hken_US
dc.identifier.authorityChan, V=rp00320en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8306473-
dc.identifier.scopuseid_2-s2.0-0028238172en_US
dc.identifier.hkuros4690-
dc.identifier.volume40en_US
dc.identifier.issue1en_US
dc.identifier.spage137en_US
dc.identifier.epage143en_US
dc.identifier.isiWOS:A1994MT62800022-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridWebster, J=7402197165en_US
dc.identifier.scopusauthoridPeters, JR=7404190775en_US
dc.identifier.scopusauthoridJohn, R=7202375301en_US
dc.identifier.scopusauthoridSmith, J=7410166837en_US
dc.identifier.scopusauthoridChan, V=7202654865en_US
dc.identifier.scopusauthoridHall, R=7404722067en_US
dc.identifier.scopusauthoridScanlon, MF=7102353622en_US

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