{"id":1657,"date":"2026-01-24T08:35:20","date_gmt":"2026-01-24T08:35:20","guid":{"rendered":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/2026\/01\/24\/synchronous-double-pituitary-adenoma-secreting-prolactin-lh-and-alpha-subunit-glycoprotein-a-new-mul\/"},"modified":"2026-01-24T08:35:20","modified_gmt":"2026-01-24T08:35:20","slug":"synchronous-double-pituitary-adenoma-secreting-prolactin-lh-and-alpha-subunit-glycoprotein-a-new-mul","status":"publish","type":"post","link":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/2026\/01\/24\/synchronous-double-pituitary-adenoma-secreting-prolactin-lh-and-alpha-subunit-glycoprotein-a-new-mul\/","title":{"rendered":"SYNCHRONOUS DOUBLE PITUITARY ADENOMA SECRETING PROLACTIN, LH, AND ALPHA SUBUNIT GLYCOPROTEIN: A NEW MULTIPLE ENDOCRINE NEOPLASIA TYPE 1 (MEN1) PHENOTYPE."},"content":{"rendered":"
Delmar M. Lourenço-Jr, Flavia L. Coutinho, Rodrigo A. Toledo <\/div>\n
Unidade de Endocrinologia Genetica, LlM-25, Endocrinologia, Hospital das Clinicas do Faculdade de Medicina do Un ivers ida de de Sao Paulo, Brazil. <\/div>\n
Background:<\/strong> Co-secreting pituitary adenomas represent 1020% of pituitary tumors (PIT) in MEN1 (1). Positive immunohistochemistryfor LH or FSH may be present in 15% of MEN1-related non-functioning PITs, however, the clinical\/hormonal status of LH\/FSH excess was described in only one isolated case with FSH-secreting pituitary carcinoma (1,2). All PIT subtypes were reported in MEN1, except true LH-oma (1). Also, multiple or double pituitary adenomas in MEN1, documented by MRI, have rarely been reported (3). <\/p>\n

Objectives:<\/strong> To investigate the occurrence of double and co-secreting PIT in 40 MEN1 cases from eight different MEN1 families, all harboring germ line MEN1 mutation. <\/p>\n

Results: <\/strong>PIT was diagnosed in 20 out of the 40 MEN 1 cases. Prolacti noma-only was documented in 60% (12\/20) of PIT cases, and non-functioning PIT was seen in 35%. We documented a case presenting a co-secreting PIT belonging to different adenoma types (GH-PRL-TSH and FSH\/LH). and recognized by MRI as a double adenoma. This 49 year-old male (diagnosed with hyperparathyroidism, gastrinoma, nonfunctional pancreatic tumor and microprolactinoma) has been followed up for 10 years. Prolactin was high (55 ng\/mL, normal levels: 2.0-10), showed no response to TRH, and went to normal ranges after bromoergocriptine (BEC) treatment. Total\/free testosterone and FSH were normal and LH values were normal\/high (9.7 UI\/L; NL: 1-8.4). During the administration of BEC, testosterone (1390 ng\/dL; NL, 271-965) and LH (16.9 UI\/L) increased progressively. After BEC withdrawal, prolactin showed a striking increase whereas testosterone returned to normal levels. During the follow up, it was shown a) the patient showed a progressive LH hyper-responsiveness to GnRH (from 5.3 => 33.8 UI\/L; to 12 => 70 UI\/L; NL, peak after GnRH: 12-29.7) and b) the patient had mildly high basal levels of LH. Chromatographic LH analysis revealed no other molecular forms of LH. Alpha-subunit glycoprotein levels were excessively high (4211 ng\/L; NL: 120 – 790). Double adenomas and the deviation of pituitary stalk were evident by pituitary MRI.

Conclusions: <\/strong>We described a new pituitary phenotype in MEN1 characterized by a synchronous double PIT secreting LH, prolactin, and alpha subunit. Treatment with BEC allowed us to reveal the diagnosis of LH-oma. <\/p>\n

References: <\/strong><\/p>\n

1. Verges B, etal. Pituitary disease in MEN type 1 (MEN1): data from the France-Belgium MEN1 multicenter study. Journal of Clinical Endocrinology and Metabolism 2002 87 457-465.
2. Benito M, et al. Gonadotroph tumor associated with multiple endocrine neoplasia type 1. Journal of Clinical Endocrinology and Metabolism 2005 90 570-574.
3. Sahdev A, Bilateral pituitary adenomas occurring with multiple endocrine neoplasia type one. American Journal ofNeuroradiology2000211067-1069. <\/p>\n

Support:<\/strong> RAT. is recipient of Coordenaçao de Aperfeiçoamento de Pessoal de Nfvel Superior (CAPES) PhD fellowship. D.M.L is recipient of Fundac;ao Faculdade de Medicina (FFM) pos-doctoral fellowship.<\/div>\n","protected":false},"excerpt":{"rendered":"

Delmar M. Lourenço-Jr, Flavia L. Coutinho, Rodrigo A. Toledo Unidade de Endocrinologia Genetica, LlM-25, Endocrinologia, Hospital das Clinicas do Faculdade de Medicina do Un ivers ida de de Sao Paulo, Brazil. Background: Co-secreting pituitary adenomas represent 1020% of pituitary tumors (PIT) in MEN1 (1). Positive immunohistochemistryfor LH or FSH may be present in 15% of Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[52,2,11],"tags":[],"class_list":["post-1657","post","type-post","status-publish","format-standard","hentry","category-volume-9-issue-2","category-journal-articles","category-volume-9"],"_links":{"self":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts\/1657","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/comments?post=1657"}],"version-history":[{"count":0,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/posts\/1657\/revisions"}],"wp:attachment":[{"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/media?parent=1657"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/categories?post=1657"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/peaceful-mccarthy.213-158-90-25.plesk.page\/index.php\/wp-json\/wp\/v2\/tags?post=1657"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}