Coexisting corticotroph and lactotroph adenomas: Case report with reference to the relationship of corticotropin and prolactin excess

Alan G. Wynne, Bernd W. Scheithauer, William F. Young, Kalman Kovacs, Michael J. Ebersold, Eva Horvath

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

A 57-year-old obese woman with hypertension, diabetes mellitus, osteoporosis, and a 40-year history of secondary amenorrhea was diagnosed with corticotropin-dependent Cushing's syndrome. Dynamic endocrine testing and radiological evaluation did not reveal definitively the source of the excess corticotropin. Bilateral adrenalectomy was performed with resolution of the signs and symptoms of hypercortisolism. Four years later, the patient was noted to have rising serum corticotropin levels and an enlarging pituitary mass; hyperprolactinemia also was documented. A diagnosis of Nelson-Salassa syndrome was made, and she underwent a transsphenoidal adenomectomy. A histological examination of the specimen revealed two distinct, albeit contiguous, adenomas: a corticotroph adenoma and a lactotroph adenoma. Postoperatively, the serum prolactin and corticotropin levels decreased significantly. Although the stalk section effect resulting from compression by a pituitary adenoma can raise serum prolactin levels, a concurrent lactotroph adenoma should be considered in patients with nonfunctional or functional pituitary adenomas of other types associated with significantly elevated prolactin levels. The mechanisms underlying simultaneous adrenocorticotropic hormone and prolactin excess are discussed.

Original languageEnglish (US)
Pages (from-to)919-922
Number of pages4
JournalNeurosurgery
Volume30
Issue number6
DOIs
StatePublished - Jun 1992

Keywords

  • Cushing's syndrome
  • Hyperprolactinemia
  • Multiple adenomas
  • Nelson-salassa syndrome
  • Pituitary adenoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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