Endocrine Abstracts

Introduction: Ectopic somatotroph adenomas are very rare and their mechanism is still debated. Our aim was to report 2 cases: One was located in the clivus and the other one in the supra sella area.

Case 1

A woman aged 45 years old, treated for post surgical hypothyroidism, was diagnosed as acromegaly by the family doctor. Growth hormone (GH)=44 ng/ml, IGF1=504 ng/ml (150–350). Prolactin (PRL)=37 ng/ml. The rest of pituitary function was normal. Cerebral MRI showed a tumor measuring 16×14mm located in the clivus with pituitary empty sella.

Case 2

A young woman aged 24 consulted for secondary amenorrhea. Clinical examination argued for acromegaly. Hormonal assessment confirmed the diagnosis as GH=76 ng/ml, IGF1=563 ng/ml (105–217), PRL=15 ng/ml. The rest of pituitary function was normal. MRI showed an intra and supra sella tumor measuring 24×19×16 mm without cavernous system invasion. She was operated on, but the resection was partial as the post operative tumor height was 12 mm. Immunohistochemical study argued for pure somatotroph adenoma. Then after she was treated by somatostatin analogues with a good result as only a 6 mm tumor located in the infundibular area, near the chiasm, persisted. The diagnosis of ectopic pituitary adenoma was made in retrospect.

Conclusion: The two somatotroph adenomas are considered as ectopic: One in the clivus and the other in the infundibular area: the last one was diagnosed retrospectively after tumor shrinkage under somatostatin analogues.