말단 비대증을 동반한 갑상선자극호르몬 분비 뇌하수체 선종 1예

Abstract

Growth hormone (GH) and thyrotropin (TSH)-secreting pituitary adenomas are very rare and account for only 0.5% of all pituitary adenomas. We report a case of a GH/TSH-secreting pituitary adenoma in a 53-year-old male patient. He presented with symptoms of thyrotoxicosis, clinical features of acromegaly, and diabetes mellitus. The laboratory examinations showed high serum levels of free T4, TSH, and free alpha-subunit. Additionally, serum levels of GH and insulin-like growth factor (IGF-1) were increased. GH was not suppressed below 1 μg/L by an oral 75 g glucose loading test, and TSH was not stimulated by thyrotropin- releasing hormone. A sellar MRI showed a large lobulated mass on the pituitary gland, so transcranial surgery was performed. Immunohistochemical staining showed anti-GH and anti-TSH positive tumor cells in the cytoplasm. Serum GH, IGF-1, free T4, and TSH levels normalized after surgery. (Korean J Med 77:S97-S102, 2009) Key Words: Thyrotrophs; Pituitary neoplasm; Acromegaly

갑상선자극호르몬과 성장호르몬을 함께 분비하는 뇌하수 체 선종은 매우 드물다. 말단 비대증을 동반한 갑상선기능항 진증 환자에서 갑상선자극호르몬과 성장호르몬을 함께 분비 하는 뇌하수체 선종을 진단하고 수술 치료 후 갑상선 호르 몬과 성장호르몬이 정상화된 증례를 경험하였기에 보고하고 자 한다. 중심 단어: 갑상샘자극세포; 뇌하수체 종양; 말단비대증