Isolated Adrenocorticotrophin Deficiency Associated with Anti-Pituitary Antibodies, Pituitary Cyst, Sphenoidal Cyst and Pineal Tumor

Kazumi Notsu, Nobuyuki Oka, Motoi Sohmiya, Toshiaki Sato, Yuzuru Kato, Seiichi Ando, Kozo Moritake, Ken Ichi Inada, Yoshiyuki Osamura

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

This Paper Reports A Rare Case Of Isolated Acth Deficiency Associated With Anti-Pituitary Antibodies, Pituitary Cyst, Sphenoidal Cyst And Pineal tumor. A 68-year-old man consulted our clinic for general fatigue. Laboratory data showed low plasma adrenocorticotrophin (ACTH) and cortisol levels with blunted responses to insulin-induced hypoglycemia and corticotrophin releasing factor (CRF). Urinary 17-OHCS was low but responded to ACTH-Z administration. No other pituitary functions were impaired. Antibodies to the cytoplasm of rat pituitary and the surface of GH3 cells were detected in the serum. The magnetic resonance imaging (MRI) showed a high signal intensity mass in the anterior pituitary and in the sphenoidal sinus in both T1 and T2 weighted images as well as a low signal intensity mass in a T1 weighted image of the pineal region. Transsphenoidal surgery was performed to resect the mass in the sphenoid sinus and in the pituitary. Pathological studies showed a benign cyst in the sphenoid sinus, and fibrous degeneration and decreased basophils in the pituitary. No infiltrative mononuclear cells were detected in the pituitary. Immunohistochemical studies revealed a decrease in the number of ACTH-producing cells in the pituitary. The patient was well maintained by glucocorticoid replacement without any growth of a possibly benign pineal tumor.

Original languageEnglish
Pages (from-to)631-637
Number of pages7
Journalendocrine journal
Volume41
Issue number6
DOIs
Publication statusPublished - 1994

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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