Contiguous Double Pituitary Adenomas Secreting the Same Hormones
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https://doi.org/10.5281/zenodo.7771205Keywords:
double pituitary adenoma, transsphenoidal surgery, hormone, magnetic resonance imagingAbstract
The aim of this study is to investigate the importance of intraoperative observation in the diagnosis of the contiguous double pituitary adenomas secreting the same hormone which cannot be detected as double pituitary adenoma on (CE)-T1W1 magnetic resonance imaging.
400 patients with pituitary adenoma (PA) treated by transsphenoidal surgery (TSS) were investigated retrospectively.
During the operation, we saw that the PA consisted of two pieces of two different colors and hardness. Biopsies were taken from these two different regions.
Specimens were stained with hematoxylin and eosin staining (H&E). Each pathological section was subjected to immunohistochemical staining with an avidin biotin-peroxidase complex system.
The intensity values of both contrast enhancing and non-enhancing region of the PA and normal pituitary were measured on preoperative CE-T1W1 magnetic resonance imaging (MRI).Their clinical data and MRI findings were analyzed.
The CDPA secreting the same hormone was diagnosed in 6 patients. 4 (0,1%) patients had prolactinoma, 1 patient (0,25%) had CDPA secreting growth hormone ,1 patient (0,25%) had CDPA secreting ACTH. The prolactinomas were macroadenomas, the others were microadenomas.
Immunohistochemical staining of pathological samples taken from two different regions with different morphological features of the PA revealed that these cells were mainly positive for the same hormones.
The CDPA secreting the same hormone appeared as hypointense or hyperintences on (CE)-T1W1 MRI. The CDPA secreting the same hormone appeared as PA on (CE)-T1W1 MRI.
The CDPA secreting the same hormones is difficult to diagnosis as DPA on CE-T1W1 MRI. Intraoperative detection of color and consistency changes in different parts of the PA is very important in the diagnosis of the CDPA the secreting same hormone.
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