Clinical case of a young woman with acromegaly, hyperprolactinemia and pituitary tumour with mixed morphology of adenoma and gangliocytoma

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Introduction: Acromegaly is a rare disorder that develops due to persistent hypersecretion of somatotropic hormone in adults after closure of the growth plates. In the majority of cases, the cause is a pituitary adenoma.

Aim(s): To report a case of a young woman with acromegaly, hyperprolactinemia, and mixed pituitary tumour with morphology of adenoma and gangliocytoma.

Materials and methods: A 37-year-old female presented to the clinic with complaints of increasing shoe size, enlargement of the tongue, memory disorders, galactorrhoea on expression and secondary amenorrhea. A magnetic resonance imaging demonstrated a sellar lesion with heterogeneous structure measuring 43/40 mm. From the examinations performed hypersecretion of growth hormone and prolactin was established. Somatoprolactinoma was suspected, but the possibility of а co-existence of a somatotropinoma and functional hyperprolactinemia due to pituitary stalk compression was also considered. She was referred for emergency surgical treatment. Histologically, a mixed pituitary adenoma-gangliocytoma was described. Immunohistochemical staining showed positivity for Synaptophysin and S-protein, Ki-67: 4-5%. Due to persistent disease activity, therapy with somatostatin analogue was initiated.

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Authors: Markova M, Kirova I, Elenkova A, Robeva R, Zacharieva S,

Keywords: acromegaly, hyperprolactinemia, pituitary adenoma, gangliocytoma,