Two-step development of a pituitary adenoma: From hyperprolactinemic syndrome to Cushing's disease

R. G. Gheri, W. Boddi, F. Ammannati, J. Olivotto, C. Nozzoli, A. Franchi, L. Bordi, M. L E Luisi, P. Mennonna

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

In this report we describe the case of a young female patient with amenorrhea-galactorrhea syndrome apparently due to pituitary PRL-secreting adenoma who, after three years of dopaminergic therapy without any shrinkage of the tumor, developed true Cushing's disease. Progression from hyperprolactinemia to hypersecretion of ACTH has been rarely described and it may be due to different possibilities. However, histopathological and immunohistochemical studies of the adenoma showed a pattern of PRL negative and ACTH positive cells, excluding mixed pituitary tumor. In order to explain the progression from hyperprolactinemia with amenorrhea-galactorrhea to an ACTH hypersecretion syndrome, it must be hypothesized either pituitary stalk compression or the influence of paracrine regulation factor(s) (such as Galanine) due to an 'initially silent' corticotropinoma. This case confirms that the presence of hyperprolactinemia in a patient with pituitary tumor and amenorrhea-galactorrhea syndrome is insufficient to confidently conclude for prolactinoma. Furthermore, it underlines the importance both of clinically monitoring the patient with prolactin pituitary adenoma if dopaminergic therapy does not reduce tumor volume, and of accurately and repeatedly measuring the other pituitary hormonal secretions.

Original languageEnglish
Pages (from-to)240-244
Number of pages5
JournalJournal of Endocrinological Investigation
Volume20
Issue number4
Publication statusPublished - Apr 1997

Fingerprint

Pituitary ACTH Hypersecretion
Hyperprolactinemia
Pituitary Neoplasms
Adrenocorticotropic Hormone
Prolactinoma
Galactorrhea
Amenorrhea
Physiologic Monitoring
Pituitary Gland
Tumor Burden
Prolactin
Adenoma
Therapeutics
Neoplasms
Nonpuerperal galactorrhea

Keywords

  • Cushing's disease
  • Hyperprolactinemia
  • Pituitary adenoma
  • Silent adenoma

ASJC Scopus subject areas

  • Endocrinology

Cite this

Gheri, R. G., Boddi, W., Ammannati, F., Olivotto, J., Nozzoli, C., Franchi, A., ... Mennonna, P. (1997). Two-step development of a pituitary adenoma: From hyperprolactinemic syndrome to Cushing's disease. Journal of Endocrinological Investigation, 20(4), 240-244.

Two-step development of a pituitary adenoma : From hyperprolactinemic syndrome to Cushing's disease. / Gheri, R. G.; Boddi, W.; Ammannati, F.; Olivotto, J.; Nozzoli, C.; Franchi, A.; Bordi, L.; Luisi, M. L E; Mennonna, P.

In: Journal of Endocrinological Investigation, Vol. 20, No. 4, 04.1997, p. 240-244.

Research output: Contribution to journalArticle

Gheri, RG, Boddi, W, Ammannati, F, Olivotto, J, Nozzoli, C, Franchi, A, Bordi, L, Luisi, MLE & Mennonna, P 1997, 'Two-step development of a pituitary adenoma: From hyperprolactinemic syndrome to Cushing's disease', Journal of Endocrinological Investigation, vol. 20, no. 4, pp. 240-244.
Gheri RG, Boddi W, Ammannati F, Olivotto J, Nozzoli C, Franchi A et al. Two-step development of a pituitary adenoma: From hyperprolactinemic syndrome to Cushing's disease. Journal of Endocrinological Investigation. 1997 Apr;20(4):240-244.
Gheri, R. G. ; Boddi, W. ; Ammannati, F. ; Olivotto, J. ; Nozzoli, C. ; Franchi, A. ; Bordi, L. ; Luisi, M. L E ; Mennonna, P. / Two-step development of a pituitary adenoma : From hyperprolactinemic syndrome to Cushing's disease. In: Journal of Endocrinological Investigation. 1997 ; Vol. 20, No. 4. pp. 240-244.
@article{e63da58f0e114e839a767c76175091d3,
title = "Two-step development of a pituitary adenoma: From hyperprolactinemic syndrome to Cushing's disease",
abstract = "In this report we describe the case of a young female patient with amenorrhea-galactorrhea syndrome apparently due to pituitary PRL-secreting adenoma who, after three years of dopaminergic therapy without any shrinkage of the tumor, developed true Cushing's disease. Progression from hyperprolactinemia to hypersecretion of ACTH has been rarely described and it may be due to different possibilities. However, histopathological and immunohistochemical studies of the adenoma showed a pattern of PRL negative and ACTH positive cells, excluding mixed pituitary tumor. In order to explain the progression from hyperprolactinemia with amenorrhea-galactorrhea to an ACTH hypersecretion syndrome, it must be hypothesized either pituitary stalk compression or the influence of paracrine regulation factor(s) (such as Galanine) due to an 'initially silent' corticotropinoma. This case confirms that the presence of hyperprolactinemia in a patient with pituitary tumor and amenorrhea-galactorrhea syndrome is insufficient to confidently conclude for prolactinoma. Furthermore, it underlines the importance both of clinically monitoring the patient with prolactin pituitary adenoma if dopaminergic therapy does not reduce tumor volume, and of accurately and repeatedly measuring the other pituitary hormonal secretions.",
keywords = "Cushing's disease, Hyperprolactinemia, Pituitary adenoma, Silent adenoma",
author = "Gheri, {R. G.} and W. Boddi and F. Ammannati and J. Olivotto and C. Nozzoli and A. Franchi and L. Bordi and Luisi, {M. L E} and P. Mennonna",
year = "1997",
month = "4",
language = "English",
volume = "20",
pages = "240--244",
journal = "Journal of Endocrinological Investigation",
issn = "0391-4097",
publisher = "Springer International Publishing",
number = "4",

}

TY - JOUR

T1 - Two-step development of a pituitary adenoma

T2 - From hyperprolactinemic syndrome to Cushing's disease

AU - Gheri, R. G.

AU - Boddi, W.

AU - Ammannati, F.

AU - Olivotto, J.

AU - Nozzoli, C.

AU - Franchi, A.

AU - Bordi, L.

AU - Luisi, M. L E

AU - Mennonna, P.

PY - 1997/4

Y1 - 1997/4

N2 - In this report we describe the case of a young female patient with amenorrhea-galactorrhea syndrome apparently due to pituitary PRL-secreting adenoma who, after three years of dopaminergic therapy without any shrinkage of the tumor, developed true Cushing's disease. Progression from hyperprolactinemia to hypersecretion of ACTH has been rarely described and it may be due to different possibilities. However, histopathological and immunohistochemical studies of the adenoma showed a pattern of PRL negative and ACTH positive cells, excluding mixed pituitary tumor. In order to explain the progression from hyperprolactinemia with amenorrhea-galactorrhea to an ACTH hypersecretion syndrome, it must be hypothesized either pituitary stalk compression or the influence of paracrine regulation factor(s) (such as Galanine) due to an 'initially silent' corticotropinoma. This case confirms that the presence of hyperprolactinemia in a patient with pituitary tumor and amenorrhea-galactorrhea syndrome is insufficient to confidently conclude for prolactinoma. Furthermore, it underlines the importance both of clinically monitoring the patient with prolactin pituitary adenoma if dopaminergic therapy does not reduce tumor volume, and of accurately and repeatedly measuring the other pituitary hormonal secretions.

AB - In this report we describe the case of a young female patient with amenorrhea-galactorrhea syndrome apparently due to pituitary PRL-secreting adenoma who, after three years of dopaminergic therapy without any shrinkage of the tumor, developed true Cushing's disease. Progression from hyperprolactinemia to hypersecretion of ACTH has been rarely described and it may be due to different possibilities. However, histopathological and immunohistochemical studies of the adenoma showed a pattern of PRL negative and ACTH positive cells, excluding mixed pituitary tumor. In order to explain the progression from hyperprolactinemia with amenorrhea-galactorrhea to an ACTH hypersecretion syndrome, it must be hypothesized either pituitary stalk compression or the influence of paracrine regulation factor(s) (such as Galanine) due to an 'initially silent' corticotropinoma. This case confirms that the presence of hyperprolactinemia in a patient with pituitary tumor and amenorrhea-galactorrhea syndrome is insufficient to confidently conclude for prolactinoma. Furthermore, it underlines the importance both of clinically monitoring the patient with prolactin pituitary adenoma if dopaminergic therapy does not reduce tumor volume, and of accurately and repeatedly measuring the other pituitary hormonal secretions.

KW - Cushing's disease

KW - Hyperprolactinemia

KW - Pituitary adenoma

KW - Silent adenoma

UR - http://www.scopus.com/inward/record.url?scp=0030878143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030878143&partnerID=8YFLogxK

M3 - Article

C2 - 9211134

AN - SCOPUS:0030878143

VL - 20

SP - 240

EP - 244

JO - Journal of Endocrinological Investigation

JF - Journal of Endocrinological Investigation

SN - 0391-4097

IS - 4

ER -