Title:Two Cases of Double Pituitary Adenomas in a Surgical Series Over 16 Years in a Single Centre
Volume: 21
Issue: 8
Author(s): Luca Damiani*, Luca Riccioni, Daniele Nuzzi, Mariella Celico, Riccardo Panzacchi, Cecilia Ragazzini, Luigino Tosatto, Maria Teresa Nasi and Antonio Balestrieri
Affiliation:
- Endocrinology and Diabetology Unit, Hospital “M. Bufalini”, Cesena,Italy
Keywords:
Double pituitary adenomas, multiple pituitary adenomas, pituitary, acromegaly, endonasal endoscopic surgery,
ACTH adenoma, pituitary transcription factor.
Abstract:
Background: Double pituitary adenomas (DA) are two morphologically and immunohystochemically
different tumours in the same gland. They are rare, generally small adenomas and
divided in: separated, when clearly recognizable before or during surgery, and contiguous, when diagnosed
only in the following histopathological examination. Acromegaly and Cushing’s disease
are the main prevalent clinical presentation.
Objective: We described two cases of DA in a surgical series over 16 years in a single center.
Methods: In September 2018, we diagnosed a DA in a man with acromegaly (case 1). In order to
assess the presence of other cases of DA, we performed a retrospective analysis of the endonasal
endoscopically operated sellar adenomas from January 2004 to December 2019.
Results: 468 pituitary adenomas were found. A DA with a Pit-1 positive macroadenoma (GH-TSH-
PRL positive) and an ACTH microadenoma clinically silent in an acromegalic woman was retrospectively
found (case 2).
Conclusion: Our analysis confirms that DA are rare (0.4% of the pituitary adenomas) and often associated
with acromegaly. Their pre-operatively diagnosis is difficult but clinician’s awareness of
DA can improve the diagnosis. The use of pituitary transcription factors could be useful in detecting
DA.
