ホルモン分泌性下垂体腺腫(成長ホルモン過剰症及びプロラクチン過剰症)の臨床的問題点

抄録

1. Thirteen of 35 chromophobe adenoma cases revealed abnormally high blood levels of prolaction (1380-15000 ng/ml). In these cases high levels of prolactin was disclosed in the cerebrospinal fluid and the media in which the tumor specimens were incubated. Three of these 13 cases were verified to have had recurrence in 3 years after treatment, while the other 22 cases with relatively lower prolactin levels showed no recurrence. Quantitative determination on PEG, according to our own method, showed that tumor size of these abnormally high prolactin cases was larger than that of relatively lower prolactin cases. Abnormally high blood levels of prolactin were found to maintain more than 1000 ng/ml after surgery and irradiation.
2. Sixteen cases of growth hormone secreting adenoma was examined endocrinologically. From the examination of GH responsiveness to various stimuli, these 16 cases were supposed to be classified to 3 types, i.e. TRH-responsive type (8 cases), LH-RH-responsive type (4 cases) and non-responsive type (4 cases). In 5 cases of the TRH-responsive type, the basal blood levels of GH decreased significantly in one year after irradiation.
3. In three groups of pituitary adenomas, i.e. prolactin secreting adenoma (13 cases), GH secreting adenoma (16 cases) and non-functining adenoma (22 cases), the frequency of impaired ACTH and gonadotropin secretion was observed to be the highest in prolactin secreting adenomas and the lowest in GH secreting adenomas, however the frequency of impaired TSH secretion was the highest in GH secreting adenomas and the lowest in the prolactin secreting adenomas.