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

A. G. Wynne, B. W. Scheithauer, William Francis Young, K. Kovacs, M. J. Ebersold, E. Horvath, A. D. Parent, E. R. Laws

Research output: Contribution to journalArticle

26 Citations (Scopus)

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)919-923
Number of pages5
JournalNeurosurgery
Volume30
Issue number6
StatePublished - 1992

Fingerprint

ACTH-Secreting Pituitary Adenoma
Prolactinoma
Prolactin
Adrenocorticotropic Hormone
Cushing Syndrome
Pituitary Neoplasms
Nelson Syndrome
Serum
Hyperprolactinemia
Adrenalectomy
Amenorrhea
Adenoma
Osteoporosis
Signs and Symptoms
Diabetes Mellitus
Hypertension

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Wynne, A. G., Scheithauer, B. W., Young, W. F., Kovacs, K., Ebersold, M. J., Horvath, E., ... Laws, E. R. (1992). Coexisting corticotroph and lactotroph adenomas: Case report with reference to the relationship of corticotropin and prolactin excess. Neurosurgery, 30(6), 919-923.

Coexisting corticotroph and lactotroph adenomas : Case report with reference to the relationship of corticotropin and prolactin excess. / Wynne, A. G.; Scheithauer, B. W.; Young, William Francis; Kovacs, K.; Ebersold, M. J.; Horvath, E.; Parent, A. D.; Laws, E. R.

In: Neurosurgery, Vol. 30, No. 6, 1992, p. 919-923.

Research output: Contribution to journalArticle

Wynne, AG, Scheithauer, BW, Young, WF, Kovacs, K, Ebersold, MJ, Horvath, E, Parent, AD & Laws, ER 1992, 'Coexisting corticotroph and lactotroph adenomas: Case report with reference to the relationship of corticotropin and prolactin excess', Neurosurgery, vol. 30, no. 6, pp. 919-923.
Wynne, A. G. ; Scheithauer, B. W. ; Young, William Francis ; Kovacs, K. ; Ebersold, M. J. ; Horvath, E. ; Parent, A. D. ; Laws, E. R. / Coexisting corticotroph and lactotroph adenomas : Case report with reference to the relationship of corticotropin and prolactin excess. In: Neurosurgery. 1992 ; Vol. 30, No. 6. pp. 919-923.
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