Pituitary hyperplasia: case series and literature review of an under-recognised and heterogeneous condition
[摘要] Pituitary hyperplasia (PH) occurs in heterogeneous settings and remains under-recognised. Increased awareness of thiscondition and its natural history should circumvent unnecessary trans-sphenoidal surgery. We performed an observationalcase series of patients referred to a single endocrinologist over a 3-year period. Four young women were identified with PHmanifesting as diffuse, symmetrical pituitary enlargement near or touching the optic apparatus on MRI. The first womanpresented with primary hypothyroidism and likely had thyrotroph hyperplasia given prompt resolution with thyroxine.The second and third women were diagnosed with pathological gonadotroph hyperplasia due to primary gonadalinsufficiency, with histopathological confirmation including gonadal-deficiency cells in the third case where surgery couldhave been avoided. The fourth woman likely had idiopathic PH, though she had concomitant polycystic ovary syndromewhich is a debated cause of PH. Patients suspected of PH should undergo comprehensive hormonal, radiological andsometimes ophthalmological evaluation. This is best conducted by a specialised multidisciplinary team with preferencefor treatment of underlying conditions and close monitoring over surgical intervention.
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[效力级别] [学科分类] 血液学
[关键词] Adult;Female;Asian - Chinese;White;Australia;Ovaries;Pituitary;Thyroid;Pituitary;TRH;TSH;Progesterone;FSH;LH;Cortisol;Thyroxine (T4);Triiodothyronine (T3);Prolactin;Oestradiol (E2);Pituitary hyperplasia;PCOS;Hypothyroidism;Premature ovarian failure;Ovarian cancer;Idiopathic pituitary hyperplasia;Abdominal pain;Diarrhoea;Hypothyroidism;Headache;Fatigue;Galactorrhoea;Weight gain;Confusion;Cold intolerance;Amenorrhoea;Visual disturbance;Tinnitus;MRI;TSH;FT4;FT3;Thyroid function;Thyroid antibodies;Electrocardiogram;GH;IGF1;Prolactin;Oestradiol (E2);FSH;LH;Cortisol (serum);Progesterone;Transsphenoidal surgery;Thyroxine (T4);Neurosurgery;Unique/unexpected symptoms or presentations of a disease;June;2015 [时效性]
