Gigantism caused by growth hormone secreting pituitary adenoma.
10.6065/apem.2014.19.2.96
- Author:
Noorisaem RHEE
1
;
Kumi JEONG
;
Eun Mi YANG
;
Chan Jong KIM
Author Information
1. Department of Pediatrics, Chonnam National University Hospital & Medical School, Gwangju, Korea. cjkim@jnu.ac.kr
- Publication Type:Case Report
- Keywords:
Gigantism;
Pituitary adenoma;
Growth hormone
- MeSH:
Brain;
Gigantism*;
Glucose Tolerance Test;
Growth Hormone*;
Growth Hormone-Secreting Pituitary Adenoma;
Growth Plate;
Humans;
Magnetic Resonance Imaging;
Male;
Neoplasm, Residual;
Pituitary Neoplasms*;
Reoperation;
Somatostatin
- From:Annals of Pediatric Endocrinology & Metabolism
2014;19(2):96-99
- CountryRepublic of Korea
- Language:English
-
Abstract:
Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.
