Abstract
A 21-year-old male was admitted to our hospital due to hypoglycemic attack. Lavoratory data showed a high blood level of PRL (62.5ng/ml), insulin, glucagon, Ca, and parathyroid hormone due to multiple endocrine neoplasia type I (MEN I). Insulinoma and glucagonoma were found in the pancreas and extirpated. After surgery, the patient was transferred to Department of Neurosurgery in our hospital for treatment of the pituitary tumor. Magnetic resonance (MR) imaging revealed microadenoma in the pituitary gland, and the tumor was completely extirpated via a transsphenoidal approach. Immunocytological investigation of the surgical specimen showed that it was immunoreactive for PRL, GH, TSH, LH, and FSH. The patient's PRL blood level became normal postoperatively. Functional adenoma is seen more frequently in patients with MEN I -associted pituitary adenoma than in patients without MEN, especially GH- or PRL-producing tumors. The prognosis for patients with MEN I is generally determined by the clinical course of their pancreatic tumors. Therefore, the treatment strategy for the pituitary adenoma is determined by the patient's age, general condition, and pancreatic tumor prognosis.
