17-ketosteroids and Acromegaly

A 40-year-old white woman presented with hirsutism, amenorrhea, generalized fatigue, diffuse weight gain, acral changes, and coarsened facial features. Physical examination revealed mild diastolic hypertension, acromegalic features, hirsutism, and seborrhea. The growth hormone concentration was elevated and did not suppress after glucose administration. Urinary free cortisol excretion was increased and was not suppressed during a 2 mg low-dose dexamethasone suppression test. Magnetic resonance imaging of the sella demonstrated a 1.3 x 1.2 x 0.8 cm pituitary adenoma. Trans-sphenoidal resection was performed, and portions of the resected tumor were analyzed by routine pathologic methods. Histopathologic and immunohistochemical findings indicated discrete growth hormone- and adrenocorticotropic hormone-producing pituitary adenomas. Coexisting acromegaly and Cushing's syndrome due to pituitary neoplasia was previously reported in two patients. However, to the authors' knowledge, this represents the first description of a patient with acromegaly and Cushing's disease resulting from discrete synchronous adenomas of the pituitary gland as defined by modern histopathologic techniques.

Topics: 17-Ketosteroids; Acromegaly; Adenoma; Adult; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Hirsutism; Humans; Hydrocortisone; Magnetic Resonance Imaging; Pituitary Neoplasms; Reference Values; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Cortodoxone; Female; Humans; Hypothalamo-Hypophyseal System; Levodopa; Male; Metyrapone; Pituitary-Adrenal System; Stimulation, Chemical

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adenoma; Adenoma, Acidophil; Adenoma, Chromophobe; Adolescent; Adult; Aged; Amenorrhea; Carotid Arteries; Female; Follow-Up Studies; Humans; Hypophysectomy; Male; Middle Aged; Neoplasm Recurrence, Local; Optic Atrophy; Pituitary Irradiation; Pituitary Neoplasms; Pneumoencephalography

Topics: 17-Ketosteroids; Acromegaly; Androsterone; Bromocriptine; Etiocholanolone; Humans; Male

Topics: 17-Ketosteroids; Acromegaly; Adenocarcinoma, Scirrhous; Breast Neoplasms; Female; Gonadotropins; Humans; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Administration, Oral; Adrenal Glands; Adult; Aged; Blood Glucose; Carbohydrate Metabolism; Creatinine; Cryosurgery; Fasting; Female; Glucose; Glucose Tolerance Test; Growth Hormone; Humans; Hypophysectomy; Injections, Intravenous; Insulin; Male; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Thyroid Hormones; Time Factors

Topics: 17-Ketosteroids; Acromegaly; Adenoma, Chromophobe; Adult; Biopsy; Diagnosis, Differential; Humans; Male; Nasal Polyps; Nasopharynx; Pituitary Neoplasms; Radiography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Carbon Radioisotopes; Creatinine; Depression, Chemical; Dexamethasone; Female; Glucose; Growth Hormone; Half-Life; Humans; Hydrocortisone; Male; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Time Factors

Topics: 17-Ketosteroids; Acromegaly; Anesthesia, General; Cerebrospinal Fluid Rhinorrhea; Corticosterone; Cushing Syndrome; Diabetic Retinopathy; Humans; Hydrocortisone; Intubation, Intratracheal; Nasopharynx; Pituitary Gland; Pituitary Irradiation; Pneumoencephalography; Postoperative Care; Postoperative Complications; Preoperative Care; Radioisotopes; Water-Electrolyte Balance; Yttrium Isotopes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenal Gland Diseases; Bone Diseases; Cushing Syndrome; Dwarfism, Pituitary; Endocrine System Diseases; Female; Gigantism; Growth Hormone; Humans; Male; Ossification, Heterotopic; Pituitary Diseases; Radiography; Thyroid Diseases; Thyroid Hormones

Topics: 17-Ketosteroids; Acromegaly; Adult; Aged; Antigens; Blood Glucose; Cholesterol; Dihydroxyphenylalanine; Fatty Acids, Nonesterified; Female; Glucose Tolerance Test; Growth Hormone; Humans; Insulin; Male; Middle Aged; Parkinson Disease; Thyroxine; Time Factors; Triglycerides

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Aged; Androstanes; Circadian Rhythm; Female; Humans; Hydroxysteroids; Hyperaldosteronism; Hypertension; Ketosteroids; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Pregnanes; Propionates; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Aged; Cholesterol; Chromosome Mapping; Electroencephalography; Electromyography; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Male; Middle Aged; Myotonic Dystrophy; Pituitary Function Tests; Sex Factors; Skin Diseases; Thyroid Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adolescent; Adult; Androsterone; Chorionic Gonadotropin; Dehydroepiandrosterone; Endocrine System Diseases; Estrogens; Etiocholanolone; Humans; Hypogonadism; Hypopituitarism; Klinefelter Syndrome; Male; Metabolism; Middle Aged; Pregnanetriol; Puberty; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adenoma; Cardiac Catheterization; Cerebral Ventriculography; Electrocardiography; Follicle Stimulating Hormone; Heart Failure; Humans; Male; Middle Aged; Pituitary Neoplasms; Thyroid Function Tests

Topics: 17-Ketosteroids; Acromegaly; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Delayed-Action Preparations; Female; Humans; Male; Middle Aged; Peptides

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Addison Disease; Adolescent; Adult; Age Factors; Diabetes Insipidus; Female; Humans; Hypopituitarism; Hypothyroidism; Male; Middle Aged; Pituitary Diseases; Pituitary Neoplasms; Sex Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Arginine; Basal Metabolism; Cerebral Ventriculography; Endocrine Glands; Female; Glucose Tolerance Test; Gonadotropins; Gonads; Growth Hormone; Humans; Iodine; Iodine Radioisotopes; Male; Menopause; Metyrapone; Middle Aged; Pyrogens; Sella Turcica; Skull; Thyroid Function Tests; Thyroid Gland; Thyronines; Thyroxine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adolescent; Adrenocorticotropic Hormone; Adult; Blood Glucose; Child; Child, Preschool; Dwarfism, Pituitary; Electrophoresis; Female; Gonadotropins; Growth Disorders; Growth Hormone; Humans; Hyperthyroidism; Hypopituitarism; Hypothyroidism; Insulin; Ion Exchange Resins; Male; Pituitary Diseases; Radioimmunoassay; Thyroid Diseases; Thyrotropin; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Body Weight; Cholesterol; Diabetes Complications; Diabetes Mellitus; Diet; Fatty Acids, Nonesterified; Growth Hormone; Humans; Hyperlipidemias; Insulin; Lipids; Lipoproteins; Male; Phospholipids; Triglycerides; Xanthomatosis

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Animals; Breast Neoplasms; Cushing Syndrome; Diabetic Retinopathy; Dogs; Female; Humans; Hydrocortisone; Male; Methods; Middle Aged; Pituitary Gland; Prostatic Neoplasms; Ultrasonic Therapy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Dexamethasone; Female; Humans; Male; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System

Topics: 17-Ketosteroids; Acromegaly; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Female; Follow-Up Studies; Humans; Hydrocortisone; Male; Middle Aged; Pituitary-Adrenal Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Arginine; Blood; Blood Glucose; Diabetes Complications; Female; Glucose Tolerance Test; Growth Hormone; Hemorrhage; Humans; Hydrocortisone; Insulin; Islets of Langerhans; Necrosis; Osmolar Concentration; Pituitary Diseases; Thyroxine; Tolbutamide; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Addison Disease; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Anorexia Nervosa; Child; Child, Preschool; Chromatography; Cushing Syndrome; Disorders of Sex Development; Endocrine System Diseases; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hyperthyroidism; Hypertrichosis; Hypopituitarism; Male; Middle Aged; Myxedema; Obesity; Pheochromocytoma; Pregnancy; Spectrophotometry

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Aged; Bone Resorption; Calcium; Calcium Isotopes; Feces; Female; Follicle Stimulating Hormone; Growth Hormone; Humans; Hypothyroidism; Iodine Radioisotopes; Male; Middle Aged; Osteoporosis; Phosphorus; Pituitary Irradiation; Thyroid Function Tests

Topics: 17-Ketosteroids; Acromegaly; Age Determination by Skeleton; Cerebral Ventricles; Child; Female; Gigantism; Humans; Hypothalamus; Intellectual Disability; Karyotyping; Male; Skull

Topics: 17-Ketosteroids; Acromegaly; Animals; Bone Neoplasms; Breast Neoplasms; Cushing Syndrome; Diabetic Retinopathy; Dogs; Female; Humans; Hypophysectomy; Male; Methods; Neoplasm Metastasis; Pituitary Gland; Prostatic Neoplasms; Ultrasonic Therapy

Topics: 17-Ketosteroids; Acromegaly; Adult; Androgens; Chromosome Aberrations; Chromosome Disorders; Disorders of Sex Development; Humans; Hypogonadism; Infertility, Male; Klinefelter Syndrome; Male; Olfaction Disorders; Sella Turcica; Sex Chromatin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenocorticotropic Hormone; Adult; Biopsy; Female; Follicle Stimulating Hormone; Growth Hormone; Humans; Hydroxyproline; In Vitro Techniques; Male; Metyrapone; Middle Aged; Parathyroid Glands; Phosphorus; Pituitary Function Tests; Pituitary Irradiation; Pituitary-Adrenal Function Tests; Ribs; Thyroid Function Tests; Urine

Topics: 17-Ketosteroids; Acromegaly; Adult; Gynecomastia; Humans; Male; Osteoarthropathy, Secondary Hypertrophic; Radiography; Tetralogy of Fallot

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Basal Metabolism; Breast Neoplasms; Cushing Syndrome; Diabetes Mellitus; Gonadotropins; Gonadotropins, Pituitary; Humans; Hypopituitarism; Metyrapone; Pituitary Diseases; Pituitary Gland; Pituitary Irradiation; Thyroid Function Tests; Urine; Yttrium Isotopes

Topics: 17-Ketosteroids; Acromegaly; Blood; Bone Development; Carbohydrate Metabolism; Child; Genetics, Medical; Genital Diseases, Female; Gigantism; Hepatomegaly; Hirsutism; Humans; Hypertrichosis; Hypertrophy; Infant; Lipodystrophy; Lipodystrophy, Congenital Generalized; Liver Diseases; Metabolism; Muscular Diseases; Radiography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Dexamethasone; Female; Growth Hormone; Humans; Hydrocortisone; Metyrapone; Pituitary Neoplasms; Urine; Virilism

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adenoma; Adolescent; Adrenal Hyperplasia, Congenital; Adult; Blood; Child; Chromatography, Gas; Cushing Syndrome; Female; Glucuronates; Hirsutism; Humans; Hypogonadism; Klinefelter Syndrome; Male; Middle Aged; Polycystic Ovary Syndrome; Testosterone; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Castration; Cerebral Palsy; Chromatography; Congenital Abnormalities; Consanguinity; Epidemiology; Epilepsy; Epilepsy, Tonic-Clonic; Eye; Gonadotropins; Humans; Hypophysectomy; Intellectual Disability; Scalp; Scalp Dermatoses; Sex Chromatin; Sweden; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Androgens; Chromatography; Ketones; Metabolism; Mineralocorticoid Receptor Antagonists; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adrenal Insufficiency; Cushing Syndrome; Endocrine System Diseases; Humans; Hyperthyroidism; Hypoadrenocorticism, Familial

Topics: 17-Ketosteroids; Acidosis; Acromegaly; Basal Metabolism; Blood Glucose; Cholesterol; Diabetes Mellitus; Diabetic Ketoacidosis; Hand; Humans; Paresthesia; Radiotherapy; Visual Field Tests

Topics: 17-Ketosteroids; Acromegaly; Adrenocorticotropic Hormone; Biochemical Phenomena; Biochemistry; Chlorpromazine; Enzyme Inhibitors; Humans; Hypopituitarism; Metyrapone; Mixed Function Oxygenases; Pyrogens; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Androgens; Child; Cobalt; Cobalt Isotopes; Dwarfism; Dwarfism, Pituitary; Growth Hormone; Humans; Hypopituitarism; Male; Neoplasms; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Clinical Laboratory Techniques; Cushing Syndrome; Cysts; Female; Humans; Hypogonadism; Hypopituitarism; Metyrapone; Mineralocorticoid Receptor Antagonists; Neoplasms; Ovary; Pharmacology; Pituitary Gland; Pituitary Neoplasms; Radioisotope Teletherapy; Scleroderma, Systemic; Sexual Infantilism; Toxicology; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Body Fluids; Estrogens; Humans; Steroids; Testosterone; Urinary Tract

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Androgens; Cushing Syndrome; Dehydroepiandrosterone; Endocrine System Diseases; Humans; Pituitary ACTH Hypersecretion; Puberty, Precocious; Steroids; Urine

Topics: 17-Ketosteroids; Acromegaly; Adenoma; Chromatography; Growth Hormone-Secreting Pituitary Adenoma; Humans; Neoplasms; Pituitary Gland; Pituitary Neoplasms; Radiotherapy; Steroids