Two Cases of Double Pituitary Adenomas in a Surgical Series Over 16 Years in a Single Centre

Title:Two Cases of Double Pituitary Adenomas in a Surgical Series Over 16 Years in a Single Centre

Volume: 21 Issue: 8

Author(s): Luca Damiani*, Luca Riccioni, Daniele Nuzzi, Mariella Celico, Riccardo Panzacchi, Cecilia Ragazzini, Luigino Tosatto, Maria Teresa Nasi and Antonio Balestrieri

Affiliation:

• Endocrinology and Diabetology Unit, Hospital “M. Bufalini”, Cesena,Italy

Keywords: Double pituitary adenomas, multiple pituitary adenomas, pituitary, acromegaly, endonasal endoscopic surgery, ACTH adenoma, pituitary transcription factor.

Abstract:

Background: Double pituitary adenomas (DA) are two morphologically and immunohystochemically different tumours in the same gland. They are rare, generally small adenomas and divided in: separated, when clearly recognizable before or during surgery, and contiguous, when diagnosed only in the following histopathological examination. Acromegaly and Cushing’s disease are the main prevalent clinical presentation.

Objective: We described two cases of DA in a surgical series over 16 years in a single center.

Methods: In September 2018, we diagnosed a DA in a man with acromegaly (case 1). In order to assess the presence of other cases of DA, we performed a retrospective analysis of the endonasal endoscopically operated sellar adenomas from January 2004 to December 2019.

Results: 468 pituitary adenomas were found. A DA with a Pit-1 positive macroadenoma (GH-TSH- PRL positive) and an ACTH microadenoma clinically silent in an acromegalic woman was retrospectively found (case 2).

Conclusion: Our analysis confirms that DA are rare (0.4% of the pituitary adenomas) and often associated with acromegaly. Their pre-operatively diagnosis is difficult but clinician’s awareness of DA can improve the diagnosis. The use of pituitary transcription factors could be useful in detecting DA.

Cite this article as:

Damiani Luca *, Riccioni Luca , Nuzzi Daniele , Celico Mariella , Panzacchi Riccardo , Ragazzini Cecilia , Tosatto Luigino , Nasi Teresa Maria and Balestrieri Antonio , Two Cases of Double Pituitary Adenomas in a Surgical Series Over 16 Years in a Single Centre, Endocrine, Metabolic & Immune Disorders - Drug Targets 2021; 21 (8) . https://dx.doi.org/10.2174/1871530321666210203213758