Craniopharyngioma in a patient with acromegaly due to a pituitary macroadenoma

• Published in: Annals of Saudi medicine Vol. 30; no. 6; pp. 485 - 488
• Main Authors: El-Bilbeisi, Hazem, Ghannam, Mohammad, Nimri, Caramella F, Ahmad, Azmi T
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Medknow Publications and Media Pvt. Ltd 01.11.2010; KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTRE; Medknow Publications; King Faisal Specialist Hospital and Research Centre
• Subjects: Acromegaly; Acromegaly - etiology; Adenoma - metabolism; Adenoma - pathology; Apoptosis; Case Report; Case studies; Cell growth; Craniopharyngioma - diagnosis; Craniopharyngioma - pathology; Cysts; Diagnosis; Female; Growth Hormone - metabolism; Growth hormones; Headaches; Humans; Hypothyroidism; Magnetic resonance imaging; Neoplasms, Second Primary - pathology; Pathogenesis; Physiological aspects; Pituitary gland; Pituitary gland tumors; Pituitary Neoplasms - complications; Pituitary Neoplasms - metabolism; Pituitary Neoplasms - pathology; Somatotropin; Studies; Surgery; Tumors; Saudi Arabia
• ISSN: 0256-4947; 0975-4466
• DOI: 10.4103/0256-4947.70581

We present the first reported case of a craniopharyngioma as a second primary tumor in a patient with acromegaly due to a growth hormone (GH)-secreting pituitary adenoma. The patient was lost for follow-up for 18 years after trans-sphenoidal pituitary surgery for a GH-secreting pituitary adenoma. She presented with headaches and decreased visual acuity, and showed unsuppressed GH in an oral glucose load test with high IGF-1 levels. Brain MRI showed a suprasellar cystic mass and the patient underwent surgery for cyst drainage resulting in postoperative improvement in her vision. Biopsy of the mass confirmed the diagnosis of a craniopharyngioma. We stress the need for close follow-up of patients with acromegaly with adequate control of GH and IGF-1 levels.