Corticotroph Cell Adenoma without Typical Manifestations of Cushing's Disease Presenting with Cavernous Sinus Syndrome following Pituitary Apoplexy

TAKUMI ABE; YOSHIHARU SAWABE; YUBUHITO MOCHIZUKI; SHIGEKI SUNAGA; HITOSHI IZUMIYAMA; KIYOSHI MATSUMOTO; MIKI KUSHIMA; MATSUO TANIYAMA; YOSHIO BAN; TOSHIAKI SANO

doi:10.1507/endocrj.48.503

TAKUMI ABE, YOSHIHARU SAWABE, YUBUHITO MOCHIZUKI, SHIGEKI SUNAGA, HITOSHI IZUMIYAMA, KIYOSHI MATSUMOTO, MIKI KUSHIMA, MATSUO TANIYAMA, YOSHIO BAN, TOSHIAKI SANO

Author information

TAKUMI ABE
Departments of Neurosurgery, Showa University School of Medicine
YOSHIHARU SAWABE
Departments of Neurosurgery, Showa University School of Medicine
YUBUHITO MOCHIZUKI
Departments of Neurosurgery, Showa University School of Medicine
SHIGEKI SUNAGA
Departments of Neurosurgery, Showa University School of Medicine
HITOSHI IZUMIYAMA
Departments of Neurosurgery, Showa University School of Medicine
KIYOSHI MATSUMOTO
Departments of Neurosurgery, Showa University School of Medicine
MIKI KUSHIMA
Hospital Pathology, Showa University School of Medicine
MATSUO TANIYAMA
3rd Internal Medicine, Showa University School of Medicine
YOSHIO BAN
3rd Internal Medicine, Showa University School of Medicine
TOSHIAKI SANO
Department of Pathology, University of Tokushima School of Medicine

Keywords: Cavernous sinus syndrome, Pituitary adenoma, Pituitary hemorrhage, Corticotroph cell adenoma, Cushing's disease

JOURNAL FREE ACCESS

2001 Volume 48 Issue 4 Pages 503-507

DOI https://doi.org/10.1507/endocrj.48.503

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Abstract

This report presents a unique case of corticotroph cell adenoma in a 30-year-old man without acromegaly or features typical of Cushing's disease, who developed cavernous sinus syndrome following pituitary apoplexy. Magnetic resonance imaging revealed a large intrasellar/suprasellar mass with pituitary hemorrhage and extension of a hematoma to the anterior base of the skull. Urgent transnasal pituitary surgery revealed an acidophilic pituitary adenoma, with immunoreactivity for ACTH and GH and expression of proopiomelanocortin (POMC) and GH messenger ribonucleic acid (mRNA) demonstrated by in situ hybridization. To our knowledge, a silent corticotroph cell adenoma with GH production has never been reported. This type of adenoma may potentially enlarge and develop tumoral hemorrhage because it is free of endocrinological symptoms.

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