ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)
Dealing with pituitary invaders: a corticotroph macroadenoma case
Nada Ait Kassi 1 , Nouhaila Essafir 1 , Sara Hairchi 1 , Habbadi Zineb 2 , Fatima Toulali 1 , Ghizlane Sabbar 1 , Kaoutar Rifai 1 , Hinde Iraqi 1 & Mohamed El Hassan Gharbi 1
1Ibn Sina Hospital Mohamed V University, Rabat, Morocco; 2Ibn Sina Hospital Mohamed V University, Endocrinology, Rabat, Morocco
JOINT50
Introduction: Corticotroph pituitary tumors, particularly invasive macroadenomas, are rare and therapeutically challenging due to their compressive effects and systemic complications. They represent a significant cause of endogenous hypercortisolism in Cushing’s syndrome. This case discusses a complex presentation of an invasive corticotroph macroadenoma in a middle-aged woman, underlining the value of tailored multidisciplinary management to achieve biochemical and clinical control.
Case Presentation: A 46-year-old woman with a history of hypertension and type 2 diabetes was diagnosed with an invasive corticotroph macroadenoma, confirmed by histopathology after transsphenoidal surgery. Imaging revealed a sellar and suprasellar mass with bone erosion and optic chiasm compression. Post-operative complications included hypogonadism and hypothyroidism, requiring hormone replacement therapy. Medical management included ketoconazole, cabergoline, and the planned introduction of Pasireotide to address tumor control and residual hypercortisolism.
Discussion: This case highlights the aggressive nature of corticotroph macroadenomas, characterized by local invasion and systemic effects such as Cushingoid features. Surgical resection remains the first-line treatment; however, complete remission is not always achievable, necessitating adjunctive therapies. Novel pharmacological approaches expand therapeutic options, such as somatostatin analogs and ACTH secretion inhibitors. Furthermore, long-term monitoring is critical due to the potential for recurrence or progression, especially in invasive forms.
Conclusion: Invasive corticotroph macroadenomas require an integrative approach, combining surgery, medical treatment, and close follow-up. Advanced therapies, like Pasireotide, offer promising outcomes in managing persistent disease. This case underscores the importance of individualized care in achieving optimal results for complex pituitary tumors.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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