Monomorphous Plurihormonal Pituitary Adenoma of Pit-1 Lineage in a Giant Adolescent with Central Hyperthyroidism

Endocrine Pathology
Bernardo Dias PereiraSylvia L Asa

Abstract

Thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare at the pediatric age and no cases of co-secretion with other pituitary hormones in these tumors have been described in this age range. We present a case of a monomorphous plurihormonal pituitary adenoma that co-secreted TSH and GH in a pediatric patient. A 13-year-old male presented with increasing height velocity (17.75 cm/year, 9.55SD), weight loss, and visual impairment. Initial biochemical evaluations revealed secondary hyperthyroidism. A giant pituitary tumor compressing the surrounding structures was detected by magnetic resonance, and a transsphenoidal surgery was initially performed. Pathological examinations revealed an atypical, monomorphous plurihormonal Pit-1 lineage tumor with mixed features of silent subtype 3 adenoma and acidophil stem cell adenoma. In the postoperative period, secondary hyperthyroidism recurred with high levels of both GH and IGF1. In addition, due to tumor re-growth, a multimodality treatment plan was undertaken including surgery, somatostatin analogs, and radiotherapy. We report the first pediatric case of a plurihormonal TSH- and GH-secreting pituitary adenoma, further expanding the clinical manifestations of pediatric pituit...Continue Reading

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Citations

Jan 9, 2016·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Ozgur MeteSylvia L Asa
Jun 9, 2019·Journal of Endocrinological Investigation·P Beck-PeccozA Lania
Nov 14, 2019·Hormones : International Journal of Endocrinology and Metabolism·Anupriya Annapurni, Manjusha Rathi
Nov 11, 2020·Scientific Reports·Keiko Taniguchi-PoncianoMoises Mercado
Jan 22, 2021·Neurosurgery·Peter J KobalkaAline P Becker
May 22, 2021·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Sylvia L AsaUNKNOWN Attendees of the 15th Meeting of the International Pituitary Pathology Club, Istanbul October 2019

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