Endocrine Abstracts

GH secreting adenomas could be associated with clinical acromegaly with or without hyperprolactinemia, being rare cases of non functioning adenomas. They correspond a 25–30%of pituitary adenomas, generaly presented as macroadenoma.Frequently, they have another hormones production, often prolactin and TSH. Almost 75% of cases are macroadenomas. A 48-year-old Caucasian patient admitted complaining of facial craniofacial alterations, polyarthralgia, holocranial headache and paresthesia in cuffs several years ago. Amenorrhea since the age of 30. Associated comorbidities: Type 2 diabetes one year in treatment with insulin and metformin, arterial hypertension, anxiety. No family history suggestive of endocrinopathy. The physical examination showed the following randomness: cervical acanthosis and bilateral peri-ocular, mild hepatomegaly and fingers and feet in the form of sausage. Galactorrhea bilateral mamillary expression. Hemodynamically stable. Confirmed by hormonal dosages diagnosed with acromegaly, resonance of the pituitary region showed an expansive suprasellar lesion with involvement of the entire left carotid, compressing the optic chiasm and measuring 3, 1×2, 5×2, 6 cm. Initiated treatment with Octreotide LAR and forwarded to neurosurgery. The patient evolved with central hypothyroidism and was treated with levothyroxine. He performed debulking of the lesion hypophyseal eight years after the indication, in this period remained in use of the analogs of somatostatin and cabergoline. Immunohistochemistry revealed positivity for GH, PIT-1 e cytokeratin 8 with negative E-cadherin. KI-67 positive in less than 1% of the cells. It is noteworthy,that the positivity in paranuclear pattern of CAM5.2, with absence of expression in membrane for E-cadherin is compatible with the subgroup of hypophysis adenomas produced by GH, ultrastructurally characterized, with sparsely granular,exhibiting less indolent behavior in this family of tumors, this neoplasm exhibits a lower response to treatment with somatostatin analogues.