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Ann Pediatr Endocrinol Metab. 2017 Sep;22(3):197-202. doi: 10.6065/apem.2017.22.3.197. Epub 2017 Sep 28.

A rare case of multiple pituitary adenomas in an adolescent Cushing disease presenting as a vertebral compression fracture.

Author information

1
Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
2
Departments of Otorhinolaryngology, Pusan National University Yangsan Hospital, Yangsan, Korea.
3
Departments of Neurosergery, Pusan National University Yangsan Hospital, Yangsan, Korea.
4
Departments of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.
5
Departments of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

Cushing disease in children and adolescents, especially with multiple pituitary adenomas (MPAs), is very rare. We report 17-year-old boy with MPAs. He presented with a vertebral compression fracture, weight gain, short stature, headache, and hypertension. On magnetic resonance imaging (MRI), only a left pituitary microadenoma was found. After surgery, transient clinical improvement was observed but headache and hypertension were observed again after 3 months later. Follow-up MRI showed a newly developed right pituitary microadenoma 6 months after the surgery. The need for careful clinical and radiographic follow-up should be emphasized in the search for potential MPAs in patients with persistent Cushing disease.

KEYWORDS:

Adolescent; Cushing disease; Multiple pituitary adenomas; Transsphenoidal surgery

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