Endocrine Abstracts

The purpose of the study: Is to research case of re-growth of non-functional giant pituitary adenoma (NFPA) with panhypopituitarysm in 28-years old woman

Material and research methods: Patient Karimova N, was born in 1994 in Namangan region. Clinical diagnosis: Non-functional giant pituitary adenoma with total variant of growth. Status after transnasal selective adenomphysisectomy (12.04.16). Re-growth of tumor. Second transnasal selective adenomphysisectomy (26.11.2021). Complications. Panhypopituitarysm. Secondary hypogonadism, hypocorticism, hypothyroidism. Growth hormone deficiency. Bitemporal hemianopsia. Functional hyperprolactinemia. Primary infertility. Secondary amenorrhoea. The patient considers himself to be ill from 2015 year after marriage. She was operated on the occasion of pituitary adenoma with supra-infra-latero-sellar growth. Microcellular chromophobe adenoma was histologically determined. In early postoperative period the improvement of vision was marked. In late postoperative period neuroendocrine disorders were left without dynamics. As the patient wasn’t observed regularly, she received Kabergolin 5 mg twice in week during 6 months. The patient refused from radiotherapy. The worsening of state was marked for the last 6 months, when the above mentioned complaints increased.

Results of the study: Height is 156 sm, weight is 55 kg. BMI=24, 4 kg/m2. The skin coverings are pale, dry, clean. A/P=110/70 mm.mer.e. Puls rate = 72 beats per min. In blood plasma GH – 0,13 ng/ml (norma 2-5 ng/ml), IGF-1 - 88 nmol/l (norma 300 nmol/l), FSH-0,94 Med/l, LH – 0, 46 МЕd/l (norma 3-8 mME/l), cortisol in the morning – 55,1 nmol/l (norma 260-720 нмоль/л,), prolactin – 307 ng/ml (norma 7-8 ng/mi), estradiol – 17, 4 pg/ml. Ophthalmologist. Bitemporal hemianopsia on white color, absence of visual fields on green and red colors from both eyes. MRI : Pituitary macroadenoma with the size 5,6 sm x 4,3 sm x 5,4 sm The patient was operated again in our clinic. In the early postoperative period the patient was marked improving of visual fields.

Conclusions: 1. For NFPA with small cellular chromofobe cells in patients of reproductive age it is typical aggressive re-growth of tumor. 2. For prevention of re-growth of giant pituitary tumor after surgery it is necessary to conduct for patient radiotherapy.