ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
Crooke cell corticotrop adenoma: case series
Ekin Yiğit Köroğlu 1 , Çağlar Keskin 1 , Servet Güreşçi 2 , Denizhan Divanlıoğlu 3 , Cevdet Aydın 4 , Oya Topaloğlu 4 , Reyhan Ersoy 4 & Bekir Çakır 4
1Ankara Bilkent City Hospital, Endocrinology and Metabolism, Ankara; 2Ankara Bilkent City Hospital, Pathology, Ankara; 3Ankara Bilkent City Hospital, Neurosurgery, Ankara; 4Ankara Yıldırım Beyazıt University Faculty Of Medicine, Endocrinology and Metabolism, Ankara
Crooke cell corticotroph adenomas are a rare subtype of corticotroph adenomas. It can be detected in less than 1% of all pituitary adenomas. They are usually noticed as invasive macroadenomas on preoperative imaging. They are expected to have a more aggressive course and more frequent recurrences during their clinical course. We present a case series of 11 patients who were followed up with Cushing’s Disease in our clinic and were diagnosed with Crooke cell adenoma after surgery. Nine patients were female(81.8%), and 2(18.2%) were male. The average age of the patients was 41.0(19.0-71.0) years. There were macroadenomas in 6 patients(54.5%) and microadenomas in 5 patients(45.5%). The average largest tumor diameter was 14.00 (4.50-35.00) mm. Pituitary adenoma invaded surrounding tissues in 3 patients(27.3%). Optic chiasm compression was observed in 2 patients(18.2%). Preoperative hypopituitarism was present in 6 patients(54.5%). In this group of patients, macroadenoma was detected in 5 patients, and microadenoma was detected in 1. The patients’ preoperative laboratory parameters and clinical findings are given in Table 1 and Table 2, respectively. A 1-milligram dexamethasone suppression test was performed in all patients in the preoperative period, and it was found to be high in all patients. 24-hour urinary cortisol was measured in 8 patients and was high in 5. In the postoperative period, two patients could not be evaluated for remission because they continued their follow-up in another center. Biochemical remission was achieved in 4 of the other nine patients(44.4%), and biochemical remission was not achieved in 5(55.6%). Postoperative follow-up periods of patients in biochemical remission have been 33, 39, 56, and 62 months; no recurrence was observed in any patient during this period.
| Test | n | Minimum | Maximum | Mean |
| ACTH(<46 pg/ml) | 11 | 13,50 | 443,00 | 108,8455 |
| Cortisol(5.2-22.4 µg/dl) | 11 | 11,10 | 60,00 | 31,0273 |
| 1 mg dexamethasone suppression test(<1.8 µg/dl) | 9 | 3,90 | 43,56 | 21,1956 |
| 24-hour urinary cortisol(3.5-45 µg/day) | 8 | 24,66 | 2279,63 | 547,9125 |
| Midnight salivary cortisol(<0.69 µg/dl) | 4 | ,64 | 2,28 | 1,6100 |
| Clinical finding | Present | Absent |
| Central Obesity | 9(81.8%) | 2(18.2%) |
| Proximal myopathy | 3(27.3%) | 8(72.7%) |
| Moon face | 4(36.4%) | 7(63.6%) |
| Abdominal purple striae | 3(27.3%) | 8(72.7%) |
| Buffalo hump | 6(54.5%) | 5(45.5%) |
| Hirsutism | 5(62.5%) | 3(27.3%) |
| type 2 Diabetes Mellitus | 5(45.5%) | 6(54.5%) |
| Hypertension | 5(45.5%) | 6(54.5%) |
| Hyperlipidemia | 6(54.5%) | 5(45.5%) |
| Osteoporosis | 1(9.1%) | 10(90.9%) |
| History of thrombosis | 1(9.1%) | 10(90.9%) |
| Hypokalemia | 3(27.3%) | 8(72.7%) |
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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