Growth hormone-releasing pituitary microadenoma overshaded by a macroadenoma: a case of double pituitary adenomas and review of the literature

• Published in: British journal of neurosurgery 2024-10, Vol.38 (5), p.1144-7
• Main Authors: Demirci, Harun, Kahraman, Devrim, Kuzucu, Pelin, Şenol, Özde, Uğur, Kadriye Şerife, Ergün, Mehmet Ali, Keskil, Semih, Akdemir Özışık, Pınar
• Format: Article
• Language: English
• Subjects: Adenoma - pathology; Adenoma - surgery; Adult; Female; Growth Hormone-Secreting Pituitary Adenoma - pathology; Growth Hormone-Secreting Pituitary Adenoma - surgery; Humans; Magnetic Resonance Imaging; Male; Pituitary Neoplasms - pathology; Pituitary Neoplasms - surgery; Thyrotropin - metabolism
• ISSN: 0268-8697; 1360-046X; 1360-046X
• DOI: 10.1080/02688697.2022.2076806

Double pituitary adenoma is a rare entity that can pose a significant challenge. The incidence of double or multiple pituitary adenomas is ∼1% in autopsy cases and 0.4-1.3% in surgical series. Its definition varies, including 'double adenomas' in the literature in contrast to 'multiple adenomas', which is more specific and suitable. While some authors require separating topographically unique tumours, others have used a looser definition of separate immunohistochemistry. We presented the case of a 26-year-old patient with recurrent carpal tunnel syndrome symptoms, with double pituitary adenomas secreting growth hormone (GH) and thyroid-stimulating hormone (TSH). To date, 89 patients have been reported in the literature with symptomatic carpal tunnel syndrome, but only five had GH-TSH secretion. Double adenoma resection is of great importance for ensuring successful biochemical treatment. To ensure a successful operation, a careful preoperative 3T MRI examination is of great importance.