Invasive Growth Hormone Producing Pituitary Adenoma With Lymphocytic Infiltration: A Case Report and Literature Review

INTRODUCTION: We have presented a rare case of growth hormone (GH) producing pituitary adenoma with lymphocytic infiltration and brain parenchyma invasion. CASE PRESENTATION: A 37-year-old woman has presented with complaints of headache, amenorrhea and acromegalic features. Her laboratory studies showed markedly elevated levels of Insulin-like Growth Factor 1 (IGF-1), and low levels of follicle stimulating hormone and luteinizing hormone. Computerized tomography has revealed a pituitary mass without extra-sellar extension. The tumor has completely excised via trans-nasal endoscopic approach. Histologically, the tumor has diagnosed as a pituitary adenoma with GH positive cells. The serum IGF1 levels have gradually decreased to the normal range and the patient was symptom free for three and a half years when she has returned with complaint of visual impairment. The brain MRI that time has shown a supra-sellar mass growing independently into the remaining sellar part. Subsequently, surgical operation has performed via trans-nasal endoscopic approach. Histopathological and immunohistochemistry examination have revealed a rare case of growth hormone producing pituitary adenoma with brain invasion and lymphocytic infiltration. CONCLUSIONS: The aim of this publication was to present a rare case of growth hormone producing pituitary adenoma with brain invasion and lymphocytic infiltration.