ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 EP113 | DOI: 10.1530/endoabs.63.EP113

The case of recurrence of the growth non-functional pituitary macroadenoma with hypopituitarism

Kamola Alimova1, Yulduz Urmanova2, Nazira Rikhsieva2, Feruza Khodgaeva2, Simon Cudlip3 & Katherine Gilkes4

1Republican Specialized Scientific Practical Medical Center of Endocrinology of Republic of Uzbekistan named by Ya.Kh.Turakulov, Tashkent, Uzbekistan; 2Tashkent Pediatric Medical Institute, Department of child endocrinology, Tashkent, Uzbekistan; 3Oxford Radcliffe NHS Trust, Oxford, UK; 4The Walton Center, Liverpool, UK.

The aim: To examine the case of relapse, the growth of non-functional pituitary macroadenoma (NFPA).

Material and methods: Under our supervision was a patient Bekieva Karomat, born in 1985 with the diagnosis: Macroadenoma of the pituitary gland with a total growth option. (NFPA) State after the transnasal hypophysisectomy (23.01.08, TGE). Continued growth of the tumor. Re TGE (26.11.11). Hypopituitarism. Secondary hypogonadism, secondary hypocorticism, secondary hypothyroidism. Bitemporal hemianopsyia. Primary infertility. Functional hyperprolactinemia.

Complaints: No field of view from 2 side, headaches, no period, constant weakness, worse in the evening, decrease in blood pressure to 90/60 mm Hg From the anamnesis: the beginning of disease associates with marriage in 2007. The patient was operated in 2008 with supra - infra - literaterary growth. Histologically, small cell installed chromophobe adenoma. In the early postoperative period there was an improvement in vision. In the late postoperative period, neuroendocrine disorders remained without dynamics, as the patient was observed irregularly, took Cabergoline irregularly for 6 months, for the purpose of hormone replacement therapy was not. The patient refused radiation therapy. The deterioration of the state noted the last 6 months, when the above complaints intensified.

Objectively: Height 156 cm, weight 55 kg. skin pale, dry. BP 110/70 mm Hg Pulse 72 beats/min. In the analyses: STH – 0.13 ng/ml, FSH −0.94 mu/L, TSH– 4.0 Miu/L, LH – 0.46 mu/L, prolactin – 307 ng/ml, cortisol is 55.1 ng/ml, IGF-1 – 88 ng/ml, estradiol of 17.4 PG/ml For established MRI pituitary adenoma size 5.6 cm×4.3 cm×5.4 cm Marked loss of visual field entirely with 2 St to green and red, more to the left. The white – bitemporally hemianopsia. The patient was re-performed TGE prof. M. P. Powell. In the early postoperative period, the patient noted a complete improvement in visual fields. Appointed hormone replacement therapy (HRT): prednisolone, levothyroxine, femoston 1/10.

Conclusions: 1) small cell chromophobic adenoma in patients of reproductive age are characterized by a recurrent course after TGE. 2) in order to prevent recurrence of growth, radiation therapy of the pituitary gland or HRT is necessary.

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