A Study on a 21years Female Patient with Resected Pituitary Macroadenoma Presented with Persistently Raised Growth Hormone Levels and Resistant Diabetes Mellitus

Faizan Banaras; Ramish Fayyaz; Mahnoor Ashfaq; Khola Fayaz; Tehrim Tahir; Ali Raza

doi:10.70302/jpsim.v4i1.2314

Case Report

A Study on a 21years Female Patient with Resected Pituitary Macroadenoma Presented with Persistently Raised Growth Hormone Levels and Resistant Diabetes Mellitus

Faizan Banaras

Allied Ayub Teaching Hospital, Abbottabad, KPK

Ramish Fayyaz

Allied Ayub Teaching Hospital, Abbottabad, KPK

Mahnoor Ashfaq

Allied Ayub Teaching Hospital, Abbottabad, KPK

Khola Fayaz

Allied Ayub Teaching Hospital, Abbottabad, KPK

Tehrim Tahir

Allied Ayub Teaching Hospital, Abbottabad, KPK

Ali Raza

Allied Ayub Teaching Hospital, Abbottabad, KPK

✉ Correspondence: Faizan Banaras Email: faizanbanaras958@gmail.com

DOI https://doi.org/10.70302/jpsim.v4i1.2314

Volume: 4, Issue 1 Pages: 63–66 Published: 13 Feb 2023

Received: 15 Nov 2022 Accepted: 23 Nov 2022 Published Online: 13 Feb 2023

Abstract

Pituitary neuroendocrine tumors affect round about 5% of the general population. Pituitary macroadenomas have a size greater than 10mm, while microadenoma has a size less than 10mm.4 Acromegaly is a rare but fatal disorder mainly due to excessive growth hormone (GH) production from pituitary adenoma and a secondary rise in IGF-1 levels. It is characterized by physical disfigurement mainly face and limbs. The prevalence of acromegaly is 40 to 70 cases per million inhabitants with an annual incidence rate of 3 to 4 per million.5 The treatment options consist of pituitary surgery with the best approach of endonasal transsphenoidal hypophysectomy. The drugs used for prolactinoma and somatotrophic adenoma are dopamine agonists and somatostatin analogues respectively.

How to Cite This Article

Banaras F, Fayyaz R, Ashfaq M, Fayaz K, Tahir T, Raza A. A Study on a 21years Female Patient with Resected Pituitary Macroadenoma Presented with Persistently Raised Growth Hormone Levels and Resistant Diabetes Mellitus. J Pak Soc Intern Med. 2023;4(1):63–66. doi:10.70302/jpsim.v4i1.2314

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Asa SL (2011) Tumors of the Pituitary Gland. AFIP Atlas of Tumor Pathology. IV Series Armed Forces Institute of Pathology. Washington DC.
Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2007-2011 Neuro-oncol. 2014;16(4):63.
Chiloiro S, Doglietto F, Trapasso B, Lacovazzo D, Giampietro A, Di Nardo F, et al Typical and atypical pituitary adenomas: a single-center analysis of outcome and prognosis. Neuroendocrinol. 2015;101(2):143- 50.
Asa SL, Casar-Borota O, Chanson P, Delgrange E, Earls P, Ezzat S, et al.; attendees of 14th Meeting of the International Pituitary Pathology Club, Annecy, France, November 2016. From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an international pituitary pathology club proposal. Endocr Relat Cancer. 2016;24: C5–C8.
Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999; 2(1):29-41
Kane LA, Leinung MC, Scheithauer BW, Bergstralh EJ, Laws Jr ER, Groover RV et al. Pituitary adenomas in childhood and adolescence. J Clin Endocrinol Metab. 1994;79(4):1135-40.
Hardy J. Transsphenoidal surgery of hypersecreting pituitary tumors. In: Kohler PO, Ross GT (eds) Diagnosis and Treatment of Pituitary Tumors. International Congress Series No. 303. Exerpta Medica, Amsterdam, 1973; pp 179–198.
Chnasen P, Salenave S. Acromegaly. Orphanet J Rare Dis. 2008;3(1):1-17.
Scacchi M, Cavagnini F. Aromrgaly. Pituitary. 2006;9(3):297-303.
Scully C, Cawson RA. Medical problems in dentistry. 5th edition Elsevier, St Louis. 2005; pp. 95-6.
Ross DA & Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. Journal of Neurosurgery 1988;68(5):854-67.
Valdemarsson S, Bramnert M, Cronquist S, Elner A, Eneroth CM, Hedner P, Lindvall-Axelsson M, Nordstrom CH & Stromblad LG. Early postoperative basal serum GH level and the GH response to TRH in relation to the long-term outcome of surgical treatment for acromegaly: a report on 39 patients. J Intern Med. 1991;230(1):49-54.
Fahlbusch R, Honegger J & Buchfelder M. Surgical management of acromegaly. Endocrinol Metabol Clin North Am. 1992;21(5):669-92.
Arafah BM, Rosenzweig JL, Fenstermaker R, Salazar R, McBride CE & Selman W. Value of growth hormone dynamics and somatostatin C (insulin-like growth factor I) levels in predicting the long-term benefit after transsphenoidal surgery for acromegaly. J Lab Clin Med. 1987;109(3):346-54.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

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[1] Asa SL (2011) Tumors of the Pituitary Gland. AFIP Atlas of Tumor Pathology. IV Series Armed Forces Institute of Pathology. Washington DC.

[2] Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2007-2011 Neuro-oncol. 2014;16(4):63.

[3] Chiloiro S, Doglietto F, Trapasso B, Lacovazzo D, Giampietro A, Di Nardo F, et al Typical and atypical pituitary adenomas: a single-center analysis of outcome and prognosis. Neuroendocrinol. 2015;101(2):143- 50.

[4] Asa SL, Casar-Borota O, Chanson P, Delgrange E, Earls P, Ezzat S, et al.; attendees of 14th Meeting of the International Pituitary Pathology Club, Annecy, France, November 2016. From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an international pituitary pathology club proposal. Endocr Relat Cancer. 2016;24: C5–C8.

[5] Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999; 2(1):29-41

[6] Kane LA, Leinung MC, Scheithauer BW, Bergstralh EJ, Laws Jr ER, Groover RV et al. Pituitary adenomas in childhood and adolescence. J Clin Endocrinol Metab. 1994;79(4):1135-40.

[7] Hardy J. Transsphenoidal surgery of hypersecreting pituitary tumors. In: Kohler PO, Ross GT (eds) Diagnosis and Treatment of Pituitary Tumors. International Congress Series No. 303. Exerpta Medica, Amsterdam, 1973; pp 179–198.

[8] Chnasen P, Salenave S. Acromegaly. Orphanet J Rare Dis. 2008;3(1):1-17.

[9] Scacchi M, Cavagnini F. Aromrgaly. Pituitary. 2006;9(3):297-303.

[10] Scully C, Cawson RA. Medical problems in dentistry. 5th edition Elsevier, St Louis. 2005; pp. 95-6.

[11] Ross DA & Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. Journal of Neurosurgery 1988;68(5):854-67.

[12] Valdemarsson S, Bramnert M, Cronquist S, Elner A, Eneroth CM, Hedner P, Lindvall-Axelsson M, Nordstrom CH & Stromblad LG. Early postoperative basal serum GH level and the GH response to TRH in relation to the long-term outcome of surgical treatment for acromegaly: a report on 39 patients. J Intern Med. 1991;230(1):49-54.

[13] Fahlbusch R, Honegger J & Buchfelder M. Surgical management of acromegaly. Endocrinol Metabol Clin North Am. 1992;21(5):669-92.

[14] Arafah BM, Rosenzweig JL, Fenstermaker R, Salazar R, McBride CE & Selman W. Value of growth hormone dynamics and somatostatin C (insulin-like growth factor I) levels in predicting the long-term benefit after transsphenoidal surgery for acromegaly. J Lab Clin Med. 1987;109(3):346-54.