Skip to main content
Erschienen in: Pituitary 6/2017

01.08.2017

Double pituitary adenomas are most commonly associated with GH- and ACTH-secreting tumors: systematic review of the literature

verfasst von: Elizabeth Ogando-Rivas, Andrew F. Alalade, Jerome Boatey, Theodore H. Schwartz

Erschienen in: Pituitary | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Double adenomas in the pituitary gland are a rare occurrence. The ability to cure a hormone-producing adenoma with surgery is dependent on the ability to identify and completely remove the correct adenoma. The relative frequency of each subtype of hormone-secreting adenomas confirmed with magnetic resonance image (MRI), surgery and immunohistochemistry is not defined.

Methods

Following PRISMA guidelines, we performed a systematic review of PubMed Central, Google Scholar, Scopus Database, Cochrane database and Science Research, using the key-words: “double pituitary adenomas”, “multiple pituitary adenomas” and only papers where multiple or truly separate double pituitary adenomas were identified pre-surgically by MRI and/or confirmed by pathology/immunohistochemistry staining were included.

Results

We reviewed papers from 1975 to 2016 and found 17 cases with two pituitary adenomas and 1 with three pituitary adenomas. The ages ranged from 22 to 67 years old, and there were twelve females and five males. Immunohistochemical staining showed that the most common double pituitary adenomas were growth hormone (GH)- followed by adrenocorticotropic (ACTH)-secreting.

Conclusion

Double pituitary adenomas are rare but most commonly found with GH- or ACTH-producing tumors. It is critical to remove all identified possible adenomas to achieve biochemical cure and clinicians should have heightened sensitivity in patients with acromegaly or Cushing’s Disease.
Literatur
1.
Zurück zum Zitat Andrioli M, Giraldi FP, Losa M, Terreni M, Invitti C, Cavagnini F (2010) Cushing’s disease due to double pituitary ACTH-secreting adenomas: the first case report. Endocr J 57(9):833–837CrossRefPubMed Andrioli M, Giraldi FP, Losa M, Terreni M, Invitti C, Cavagnini F (2010) Cushing’s disease due to double pituitary ACTH-secreting adenomas: the first case report. Endocr J 57(9):833–837CrossRefPubMed
2.
Zurück zum Zitat Bader LJ, Carter KD, Latchaw RE, Ellis WG, Wexler JA, Watson JC (2004) Simultaneous symptomatic Rathke’s cleft cyst and GH secreting pituitary adenoma: a case report. Pituitary 7(1):3–44CrossRef Bader LJ, Carter KD, Latchaw RE, Ellis WG, Wexler JA, Watson JC (2004) Simultaneous symptomatic Rathke’s cleft cyst and GH secreting pituitary adenoma: a case report. Pituitary 7(1):3–44CrossRef
4.
Zurück zum Zitat Cannavò S, Curtò L, Lania A, Saccomanno K, Salpietro FM, Trimarchi F (1999) Unusual MRI finding of multiple adenomas in the pituitary gland: a case report and review of the literature. Magn Reson Imaging 17:633–636CrossRefPubMed Cannavò S, Curtò L, Lania A, Saccomanno K, Salpietro FM, Trimarchi F (1999) Unusual MRI finding of multiple adenomas in the pituitary gland: a case report and review of the literature. Magn Reson Imaging 17:633–636CrossRefPubMed
5.
Zurück zum Zitat Chohan MO, Levin AM, Singh R, Zhou Z, Green CL, Kazam JJ, Tsiouris AJ, Anand VK, Schwartz TH (2016) Two-dimensional planar measurements versus three-dimensional volumetric measurements in defining giant adenoma surgery outcomes. J Neurol Surg Part B 77(S 01):A121 Chohan MO, Levin AM, Singh R, Zhou Z, Green CL, Kazam JJ, Tsiouris AJ, Anand VK, Schwartz TH (2016) Two-dimensional planar measurements versus three-dimensional volumetric measurements in defining giant adenoma surgery outcomes. J Neurol Surg Part B 77(S 01):A121
6.
Zurück zum Zitat Davis FG, Kupelian V, Freels S, McCarthy B, Surawicz T (2001) Prevalence estimates for primary brain tumors in the United States by behavior and major histology groups. Neuro-Oncology 3(3):152–158CrossRefPubMedPubMedCentral Davis FG, Kupelian V, Freels S, McCarthy B, Surawicz T (2001) Prevalence estimates for primary brain tumors in the United States by behavior and major histology groups. Neuro-Oncology 3(3):152–158CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat de Oliveira Andrade LJ, Santos França L, Santos França L, Cordeiro de Almeida MA (2010) Double pituitary prolactinoma. J Clin Endocrinol Metab 95(11):4848–4849CrossRefPubMed de Oliveira Andrade LJ, Santos França L, Santos França L, Cordeiro de Almeida MA (2010) Double pituitary prolactinoma. J Clin Endocrinol Metab 95(11):4848–4849CrossRefPubMed
8.
Zurück zum Zitat Eytan S, Kim KY, Bleich D, Raghuwanshi M, Eloy JA, Liu JK (2015) Isolated double pituitary adenomas: a silent corticotroph adenoma and a microprolactinoma. J Clin Neurosci 22(10):1676–1678CrossRefPubMed Eytan S, Kim KY, Bleich D, Raghuwanshi M, Eloy JA, Liu JK (2015) Isolated double pituitary adenomas: a silent corticotroph adenoma and a microprolactinoma. J Clin Neurosci 22(10):1676–1678CrossRefPubMed
9.
Zurück zum Zitat Fliers E, Korbonits M, Romijn JA (2014) Nonfunctioning pituitary tumors. Clin Neuroendocrinol 28:167 Fliers E, Korbonits M, Romijn JA (2014) Nonfunctioning pituitary tumors. Clin Neuroendocrinol 28:167
10.
Zurück zum Zitat Goldberg AS, Stein R, Merritt NH, Inculet R, Van Uum S (2014) A pediatric patient with Cushing syndrome caused by ectopic ACTH syndrome and concomitant pituitary incidentalomas. J Pediatr Endocrinol Metab 27(1–2):123–128PubMed Goldberg AS, Stein R, Merritt NH, Inculet R, Van Uum S (2014) A pediatric patient with Cushing syndrome caused by ectopic ACTH syndrome and concomitant pituitary incidentalomas. J Pediatr Endocrinol Metab 27(1–2):123–128PubMed
11.
Zurück zum Zitat Hashimoto N, Handa H, Yamagami T, Kojima M, Aoki M, Okamoto S, Kato Y, Imura H (1984) Acromegaly with multiple secreting pituitary adenomas. Surg Neurol 22(6):556–558CrossRefPubMed Hashimoto N, Handa H, Yamagami T, Kojima M, Aoki M, Okamoto S, Kato Y, Imura H (1984) Acromegaly with multiple secreting pituitary adenomas. Surg Neurol 22(6):556–558CrossRefPubMed
12.
Zurück zum Zitat Hofstetter C, Mannah RM, Mubita L, Anand VK, Dehdashti A, Schwartz TH (2010) Endoscopic endonasal approach for growth-hormone secreting pituitary adenomas. Neurosurg Focus 29(4):E6CrossRefPubMed Hofstetter C, Mannah RM, Mubita L, Anand VK, Dehdashti A, Schwartz TH (2010) Endoscopic endonasal approach for growth-hormone secreting pituitary adenomas. Neurosurg Focus 29(4):E6CrossRefPubMed
13.
Zurück zum Zitat Hofstetter C, Nanszko M, Mubita L, Tsiousris J, Anand V, Schwartz T (2011) Volumetric classification for giant pituitary macroadenomas predicts outcome and morbidity of endoscopic endonasal transsphenoidal surgery. Skull Base 21(S 01):A122CrossRef Hofstetter C, Nanszko M, Mubita L, Tsiousris J, Anand V, Schwartz T (2011) Volumetric classification for giant pituitary macroadenomas predicts outcome and morbidity of endoscopic endonasal transsphenoidal surgery. Skull Base 21(S 01):A122CrossRef
14.
Zurück zum Zitat Hofstetter CP, Shin BJ, Mubita L, Huang C, Anand VK, Boockvar JA, Schwartz TH (2011) Endoscopic endonasal transsphenoidal surgery for functional pituitary adenomas. Neurosurg Focus 30(4):E10CrossRefPubMed Hofstetter CP, Shin BJ, Mubita L, Huang C, Anand VK, Boockvar JA, Schwartz TH (2011) Endoscopic endonasal transsphenoidal surgery for functional pituitary adenomas. Neurosurg Focus 30(4):E10CrossRefPubMed
15.
Zurück zum Zitat Jastania RA, Alsaad KO, Al-Shraim M, Kovacs K, Asa SL (2005) Double adenomas of the pituitary: transcription factors Pit-1, T-pit, and SF-1 identify cytogenesis and differentiation. Endocr Pathol 16(3):187–194CrossRefPubMed Jastania RA, Alsaad KO, Al-Shraim M, Kovacs K, Asa SL (2005) Double adenomas of the pituitary: transcription factors Pit-1, T-pit, and SF-1 identify cytogenesis and differentiation. Endocr Pathol 16(3):187–194CrossRefPubMed
16.
Zurück zum Zitat Kannan S, Staugaitis SM, Weil RJ, Hatipoglu B (2012) A rare corticotroph-secreting tumor with coexisting prolactin and growth hormone staining cells. Case Rep Endocrinol 2012. doi:10.1155/2012/529730 Kannan S, Staugaitis SM, Weil RJ, Hatipoglu B (2012) A rare corticotroph-secreting tumor with coexisting prolactin and growth hormone staining cells. Case Rep Endocrinol 2012. doi:10.​1155/​2012/​529730
17.
Zurück zum Zitat Karavitaki N, Scheithauer BW, Watt J, Ansorge O, Moschopoulos M, Llaguno AV et al (2008) Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke’s cleft cyst with corticotroph adenoma. Pituitary 11(3):317–323CrossRefPubMed Karavitaki N, Scheithauer BW, Watt J, Ansorge O, Moschopoulos M, Llaguno AV et al (2008) Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke’s cleft cyst with corticotroph adenoma. Pituitary 11(3):317–323CrossRefPubMed
18.
Zurück zum Zitat Kim K, Yamada S, Usui M, Sano T (2004) Preoperative identification of clearly separated double pituitary adenomas. Clin Endocrinol 61(1):26–30CrossRef Kim K, Yamada S, Usui M, Sano T (2004) Preoperative identification of clearly separated double pituitary adenomas. Clin Endocrinol 61(1):26–30CrossRef
19.
Zurück zum Zitat Kobayashi Y, Takei M, Ohkubo Y, Kakizawa Y, Matoba H, Kumagai M, Takeda T, Suzuki S, Komatsu M (2014) A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor. Endocr J 61(6):589–595CrossRefPubMed Kobayashi Y, Takei M, Ohkubo Y, Kakizawa Y, Matoba H, Kumagai M, Takeda T, Suzuki S, Komatsu M (2014) A somatotropin-producing pituitary adenoma with an isolated adrenocorticotropin-producing pituitary adenoma in a female patient with acromegaly, subclinical Cushing’s disease and a left adrenal tumor. Endocr J 61(6):589–595CrossRefPubMed
20.
Zurück zum Zitat Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of giant pituitary adenomas. Pituitary 15(2):150–159CrossRefPubMed Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of giant pituitary adenomas. Pituitary 15(2):150–159CrossRefPubMed
21.
Zurück zum Zitat Kontogeorgos G, Scheithauer BW, Kovacs K, Lloyd RV, Smyth HS, Rologis D (1992) Double adenomas of the pituitary: a clinicopathological study of 11 tumors. Neurosurgery 31(5):840–853CrossRefPubMed Kontogeorgos G, Scheithauer BW, Kovacs K, Lloyd RV, Smyth HS, Rologis D (1992) Double adenomas of the pituitary: a clinicopathological study of 11 tumors. Neurosurgery 31(5):840–853CrossRefPubMed
22.
Zurück zum Zitat Koutourousiou M, Kontogeorgos G, Wesseling P, Grotenhuis AJ, Seretis A (2010) Collision sellar lesions: experience with eight cases and review of the literature. Pituitary 13(1):8–17CrossRefPubMed Koutourousiou M, Kontogeorgos G, Wesseling P, Grotenhuis AJ, Seretis A (2010) Collision sellar lesions: experience with eight cases and review of the literature. Pituitary 13(1):8–17CrossRefPubMed
24.
Zurück zum Zitat Magri F, Villa C, Locatelli D, Scagnelli P, Lagonigro MS, Morbini P, Castellano M, Gabellieri E, Rotondi M, Solcia E, Daly AF (2010) Prevalence of double pituitary adenomas in a surgical series: clinical, histological and genetic features. J Endocrinol Investig 33(5):325–331CrossRef Magri F, Villa C, Locatelli D, Scagnelli P, Lagonigro MS, Morbini P, Castellano M, Gabellieri E, Rotondi M, Solcia E, Daly AF (2010) Prevalence of double pituitary adenomas in a surgical series: clinical, histological and genetic features. J Endocrinol Investig 33(5):325–331CrossRef
25.
Zurück zum Zitat McKelvie PA, McNeill P (2002) Double pituitary adenomas: a series of three patients. Pathology 34(1):57–60CrossRefPubMed McKelvie PA, McNeill P (2002) Double pituitary adenomas: a series of three patients. Pathology 34(1):57–60CrossRefPubMed
26.
Zurück zum Zitat Mehta GU, Montgomery BK, Raghavan P, Sharma S, Nieman LK, Patronas N, Oldfield EH, Chittiboina P (2015) Different imaging characteristics of concurrent pituitary adenomas in a patient with Cushing’s disease. J Clin Neurosci 22(5):891–894CrossRefPubMedPubMedCentral Mehta GU, Montgomery BK, Raghavan P, Sharma S, Nieman LK, Patronas N, Oldfield EH, Chittiboina P (2015) Different imaging characteristics of concurrent pituitary adenomas in a patient with Cushing’s disease. J Clin Neurosci 22(5):891–894CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Meij BP, Lopes MB, Vance ML, Thorner MO, Laws ER (2000) Double pituitary lesions in three patients with Cushing’s disease. Pituitary 3(3):159–168CrossRefPubMed Meij BP, Lopes MB, Vance ML, Thorner MO, Laws ER (2000) Double pituitary lesions in three patients with Cushing’s disease. Pituitary 3(3):159–168CrossRefPubMed
28.
Zurück zum Zitat Molitch ME (2008) Nonfunctioning pituitary tumors and pituitary incidentalomas. Endocrinol Metab Clin North Am 37(1):151–171CrossRefPubMed Molitch ME (2008) Nonfunctioning pituitary tumors and pituitary incidentalomas. Endocrinol Metab Clin North Am 37(1):151–171CrossRefPubMed
29.
Zurück zum Zitat Molitch ME (2009) Pituitary tumors: pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 23(5):667–675CrossRefPubMed Molitch ME (2009) Pituitary tumors: pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 23(5):667–675CrossRefPubMed
30.
Zurück zum Zitat Negm HM, Al-Mahfoudh R, Pai M, Singh H, Cohen S, Dhandapani S, Anand VK, Schwartz TH (2016) Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas. J Neurosurg. doi:10.3171/2016.8.JNS152709 Negm HM, Al-Mahfoudh R, Pai M, Singh H, Cohen S, Dhandapani S, Anand VK, Schwartz TH (2016) Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas. J Neurosurg. doi:10.​3171/​2016.​8.​JNS152709
31.
Zurück zum Zitat Ostrom QT, Gittleman H, Farah P, Ondracek A, Chen Y, Wolinsky Y, Stroup NE, Kruchko C, Barnholtz-Sloan JS (2013) CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro-Oncology. 15(suppl_2):ii1–56 Ostrom QT, Gittleman H, Farah P, Ondracek A, Chen Y, Wolinsky Y, Stroup NE, Kruchko C, Barnholtz-Sloan JS (2013) CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro-Oncology. 15(suppl_2):ii1–56
32.
Zurück zum Zitat Pantelia E, Kontogeorgos G, Piaditis G, Rologis D (1998) Triple pituitary adenoma in Cushing’s disease: case report. Acta Neurochir 140(2):190–193CrossRefPubMed Pantelia E, Kontogeorgos G, Piaditis G, Rologis D (1998) Triple pituitary adenoma in Cushing’s disease: case report. Acta Neurochir 140(2):190–193CrossRefPubMed
33.
Zurück zum Zitat Ratliff JK, Oldfield EH (2000) Multiple pituitary adenomas in Cushing’s disease. J Neurosurg 93(5):753–761CrossRefPubMed Ratliff JK, Oldfield EH (2000) Multiple pituitary adenomas in Cushing’s disease. J Neurosurg 93(5):753–761CrossRefPubMed
34.
Zurück zum Zitat Roberts S, Borges MT, Lillehei KO, Kleinschmidt-DeMasters BK (2016) Double separate versus contiguous pituitary adenomas: MRI features and endocrinological follow up. Pituitary 19(5):472–481CrossRefPubMed Roberts S, Borges MT, Lillehei KO, Kleinschmidt-DeMasters BK (2016) Double separate versus contiguous pituitary adenomas: MRI features and endocrinological follow up. Pituitary 19(5):472–481CrossRefPubMed
35.
Zurück zum Zitat Salpietro FM, Alafaci C, Grasso G, Lucerna S, Passalacqua M, Tomasello F (1999) Transsphenoidal microsurgical selective removal of multiple (triple) adenomas of the pituitary gland. Acta Neurochir 141(4):425–428CrossRefPubMed Salpietro FM, Alafaci C, Grasso G, Lucerna S, Passalacqua M, Tomasello F (1999) Transsphenoidal microsurgical selective removal of multiple (triple) adenomas of the pituitary gland. Acta Neurochir 141(4):425–428CrossRefPubMed
36.
Zurück zum Zitat Sano T, Horiguchi H, Xu B, Li C, Hino A, Sakaki M, Kannuki S, Yamada S (1999) Double pituitary adenomas: six surgical cases. Pituitary 1(3):243–250CrossRefPubMed Sano T, Horiguchi H, Xu B, Li C, Hino A, Sakaki M, Kannuki S, Yamada S (1999) Double pituitary adenomas: six surgical cases. Pituitary 1(3):243–250CrossRefPubMed
37.
Zurück zum Zitat Shimizu C, Koike T, Sawamura Y (2004) Double pituitary adenomas with distinct histological features and immunophenotypes. J Neurol Neurosurg Psychiatry 75(1):140PubMedPubMedCentral Shimizu C, Koike T, Sawamura Y (2004) Double pituitary adenomas with distinct histological features and immunophenotypes. J Neurol Neurosurg Psychiatry 75(1):140PubMedPubMedCentral
38.
Zurück zum Zitat Singh H, Essayed WI, Cohen-Gadol A, Zada G, Schwartz TH (2016) Resection of pituitary tumors: endoscopic versus microscopic. J Neuro-Oncol 130(2):309–317CrossRef Singh H, Essayed WI, Cohen-Gadol A, Zada G, Schwartz TH (2016) Resection of pituitary tumors: endoscopic versus microscopic. J Neuro-Oncol 130(2):309–317CrossRef
39.
Zurück zum Zitat Stobo DB, Lindsay RS, Connell JM, Dunn L, Forbes KP (2011) Initial experience of 3 T versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours. Clin Endocrinol 75(5):673–677CrossRef Stobo DB, Lindsay RS, Connell JM, Dunn L, Forbes KP (2011) Initial experience of 3 T versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours. Clin Endocrinol 75(5):673–677CrossRef
40.
Zurück zum Zitat Tabaee A, Anand VK, Barrón Y, Hiltzik DH, Brown SM, Kacker A, Mazumdar M, Schwartz TH (2009) Endoscopic pituitary surgery: a systematic review and meta-analysis. J Neurosurg 111(3):545–554CrossRefPubMed Tabaee A, Anand VK, Barrón Y, Hiltzik DH, Brown SM, Kacker A, Mazumdar M, Schwartz TH (2009) Endoscopic pituitary surgery: a systematic review and meta-analysis. J Neurosurg 111(3):545–554CrossRefPubMed
41.
Zurück zum Zitat Tabaee A, Anand VK, Barrón Y, Hiltzik DH, Brown SM, Kacker A, Mazumdar M, Schwartz TH (2009) Predictors of short-term outcomes following endoscopic pituitary surgery. Clin Neurol Neurosurg 111(2):119–122CrossRefPubMed Tabaee A, Anand VK, Barrón Y, Hiltzik DH, Brown SM, Kacker A, Mazumdar M, Schwartz TH (2009) Predictors of short-term outcomes following endoscopic pituitary surgery. Clin Neurol Neurosurg 111(2):119–122CrossRefPubMed
42.
Zurück zum Zitat Tabarin A, Laurent F, Catargi B, Olivier-Puel F, Lescene R, Berge J, San Galli F, Drouillard J, Roger P, Guerin J (1998) Comparative evaluation of conventional and dynamic magnetic resonance imaging of the pituitary gland for the diagnosis of Cushing’s disease. Clin Endocrinol 49(3):293–300CrossRef Tabarin A, Laurent F, Catargi B, Olivier-Puel F, Lescene R, Berge J, San Galli F, Drouillard J, Roger P, Guerin J (1998) Comparative evaluation of conventional and dynamic magnetic resonance imaging of the pituitary gland for the diagnosis of Cushing’s disease. Clin Endocrinol 49(3):293–300CrossRef
43.
Zurück zum Zitat Tosaka M, Kohga H, Kobayashi S, Zama A, Tamura M, Murakami M, Sasaki T (2000) Double pituitary adenomas detected on preoperative magnetic resonance images: case illustration. J Neurosurg 92(2):361CrossRefPubMed Tosaka M, Kohga H, Kobayashi S, Zama A, Tamura M, Murakami M, Sasaki T (2000) Double pituitary adenomas detected on preoperative magnetic resonance images: case illustration. J Neurosurg 92(2):361CrossRefPubMed
44.
Zurück zum Zitat Vidal S, Syro L, Horvath E, Uribe H, Kovacs K (1999) Ultrastructural and immunoelectron microscopic study of three unusual plurihormonal pituitary adenomas. Ultrastruct Pathol 23(3):141–148CrossRefPubMed Vidal S, Syro L, Horvath E, Uribe H, Kovacs K (1999) Ultrastructural and immunoelectron microscopic study of three unusual plurihormonal pituitary adenomas. Ultrastruct Pathol 23(3):141–148CrossRefPubMed
45.
Zurück zum Zitat Woosley RE (1983) Multiple secreting microadenomas as a possible cause of selective transsphenoidal adenomectomy failure: case report. J Neurosurg 58(2):267–269CrossRefPubMed Woosley RE (1983) Multiple secreting microadenomas as a possible cause of selective transsphenoidal adenomectomy failure: case report. J Neurosurg 58(2):267–269CrossRefPubMed
46.
Zurück zum Zitat Zieliński G, Maksymowicz M, Podgórski J, Olszewski WT (2013) Double, synchronous pituitary adenomas causing acromegaly and Cushing’s disease. A case report and review of literature. Endocr Pathol 24(2):92–99CrossRefPubMedPubMedCentral Zieliński G, Maksymowicz M, Podgórski J, Olszewski WT (2013) Double, synchronous pituitary adenomas causing acromegaly and Cushing’s disease. A case report and review of literature. Endocr Pathol 24(2):92–99CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Bates AS, Farrell WE, Bicknell EJ, McNicol AM, Talbot AJ, Broome JC, Perrett CW, Thakker RV, Clayton RN (1997) Allelic deletion in pituitary adenomas reflects aggressive biological activity and has potential value as a prognostic marker. J Clin Endocrinol Metab 82(3):818–824PubMed Bates AS, Farrell WE, Bicknell EJ, McNicol AM, Talbot AJ, Broome JC, Perrett CW, Thakker RV, Clayton RN (1997) Allelic deletion in pituitary adenomas reflects aggressive biological activity and has potential value as a prognostic marker. J Clin Endocrinol Metab 82(3):818–824PubMed
49.
Zurück zum Zitat Oyama K, Yamada S, Hukuhara N, Hiramatsu R, Taguchi M, Yazawa M, Matsuda A, Ohmura E, Imai Y (2006) FSH-producing macroadenoma associated in a patient with Cushing’s disease. Neuro Endocrinol Lett 27(6):733–736PubMed Oyama K, Yamada S, Hukuhara N, Hiramatsu R, Taguchi M, Yazawa M, Matsuda A, Ohmura E, Imai Y (2006) FSH-producing macroadenoma associated in a patient with Cushing’s disease. Neuro Endocrinol Lett 27(6):733–736PubMed
Metadaten
Titel
Double pituitary adenomas are most commonly associated with GH- and ACTH-secreting tumors: systematic review of the literature
verfasst von
Elizabeth Ogando-Rivas
Andrew F. Alalade
Jerome Boatey
Theodore H. Schwartz
Publikationsdatum
01.08.2017
Verlag
Springer US
Erschienen in
Pituitary / Ausgabe 6/2017
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-017-0826-6

Weitere Artikel der Ausgabe 6/2017

Pituitary 6/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.