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Double pituitary adenomas in a large surgical series
PURPOSE: To explore the incidence of double pituitary adenomas in a tertiary center for pituitary surgery and asses their clinical, imaging and histopathological features. METHODS: The medical records of the patients operated on for pituitary tumors at the Department of Neurosurgery of Military Inst...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842358/ https://www.ncbi.nlm.nih.gov/pubmed/31598814 http://dx.doi.org/10.1007/s11102-019-00996-2 |
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author | Zieliński, Grzegorz Sajjad, Emir Ahmed Maksymowicz, Maria Pękul, Monika Koziarski, Andrzej |
author_facet | Zieliński, Grzegorz Sajjad, Emir Ahmed Maksymowicz, Maria Pękul, Monika Koziarski, Andrzej |
author_sort | Zieliński, Grzegorz |
collection | PubMed |
description | PURPOSE: To explore the incidence of double pituitary adenomas in a tertiary center for pituitary surgery and asses their clinical, imaging and histopathological features. METHODS: The medical records of the patients operated on for pituitary tumors at the Department of Neurosurgery of Military Institute of Medicine in Warsaw, Poland between the years 2003 and 2018 were retrospectively analyzed. Among the 3270 treated patients, the diagnosis of double pituitary adenoma was established in 22 patients. Clinical, laboratory, detailed histopathological and diagnostics imaging data were collected and analyzed. RESULTS: There were 21 cases of synchronous and one case of asynchronous double pituitary adenoma. The main clinical finding was acromegaly (12/22) followed by Cushing’s disease (3/22). The diagnosis of synchronous double pituitary adenoma was suspected in the preoperative MRI in 11 patients. In the remaining patients the diagnosis of contiguous double pituitary adenoma was confirmed in the histopathological examination. There was no predilection for gender and the mean observation time was 74.2 months. In one case of Cushing’s disease the occurrence of double pituitary adenoma led to the initial failure of achieving hormonal remission. One patient presented with double pituitary adenomas as a manifestation of Carney complex. CONCLUSIONS: Double pituitary adenoma is a rare entity that can pose a significant challenge especially in the setting of Cushing’s disease. Careful inspection of preoperative MRI and diagnostic work-up before transsphenoidal surgery and thorough histopathological microscopic examinations with immunohistochemical staining for all pituitary hormones is essential for establishing the diagnosis of double pituitary adenoma. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11102-019-00996-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6842358 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-68423582019-11-22 Double pituitary adenomas in a large surgical series Zieliński, Grzegorz Sajjad, Emir Ahmed Maksymowicz, Maria Pękul, Monika Koziarski, Andrzej Pituitary Article PURPOSE: To explore the incidence of double pituitary adenomas in a tertiary center for pituitary surgery and asses their clinical, imaging and histopathological features. METHODS: The medical records of the patients operated on for pituitary tumors at the Department of Neurosurgery of Military Institute of Medicine in Warsaw, Poland between the years 2003 and 2018 were retrospectively analyzed. Among the 3270 treated patients, the diagnosis of double pituitary adenoma was established in 22 patients. Clinical, laboratory, detailed histopathological and diagnostics imaging data were collected and analyzed. RESULTS: There were 21 cases of synchronous and one case of asynchronous double pituitary adenoma. The main clinical finding was acromegaly (12/22) followed by Cushing’s disease (3/22). The diagnosis of synchronous double pituitary adenoma was suspected in the preoperative MRI in 11 patients. In the remaining patients the diagnosis of contiguous double pituitary adenoma was confirmed in the histopathological examination. There was no predilection for gender and the mean observation time was 74.2 months. In one case of Cushing’s disease the occurrence of double pituitary adenoma led to the initial failure of achieving hormonal remission. One patient presented with double pituitary adenomas as a manifestation of Carney complex. CONCLUSIONS: Double pituitary adenoma is a rare entity that can pose a significant challenge especially in the setting of Cushing’s disease. Careful inspection of preoperative MRI and diagnostic work-up before transsphenoidal surgery and thorough histopathological microscopic examinations with immunohistochemical staining for all pituitary hormones is essential for establishing the diagnosis of double pituitary adenoma. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11102-019-00996-2) contains supplementary material, which is available to authorized users. Springer US 2019-10-09 2019 /pmc/articles/PMC6842358/ /pubmed/31598814 http://dx.doi.org/10.1007/s11102-019-00996-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Article Zieliński, Grzegorz Sajjad, Emir Ahmed Maksymowicz, Maria Pękul, Monika Koziarski, Andrzej Double pituitary adenomas in a large surgical series |
title | Double pituitary adenomas in a large surgical series |
title_full | Double pituitary adenomas in a large surgical series |
title_fullStr | Double pituitary adenomas in a large surgical series |
title_full_unstemmed | Double pituitary adenomas in a large surgical series |
title_short | Double pituitary adenomas in a large surgical series |
title_sort | double pituitary adenomas in a large surgical series |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842358/ https://www.ncbi.nlm.nih.gov/pubmed/31598814 http://dx.doi.org/10.1007/s11102-019-00996-2 |
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