Cushing  Disease in a Patient with Double Pituitary Adenomas Complicated with Diabetes Insipidus: A Case Report

Wei Hang  Kang; Ida Ilyani Adam; Norasyikin A. Wahab

doi:10.15605/jafes.039.02.05

Authors

Wei Hang Kang Universiti Tunku Abdul Rahman https://orcid.org/0000-0003-3209-7196
Ida Ilyani Adam Ministry of Health Malaysia
Norasyikin A. Wahab National University of Malaysia https://orcid.org/0000-0002-1168-217X

DOI:

https://doi.org/10.15605/jafes.039.02.05

Keywords:

double pituitary adenoma, Cushing disease, diabetes insipidus, adrenocorticotropic hormone-secreting pituitary adenoma

Abstract

Managing a patient with both pituitary hypersecretory and hyposecretory manifestations may be perplexing. We report a 14-year-old female who presented with weight gain, polyuria and polydipsia. Biochemical results were consistent with Cushing disease with central diabetes insipidus. Pituitary magnetic resonance imaging showed right adenoma with stalk thickening. The immunohistochemistry staining of both adenomas was positive for adrenocorticotropic hormone, thyroid stimulating hormone, growth hormone and luteinizing hormone. Postoperatively, the patient developed panhypopituitarism with persistent diabetes insipidus. The coexistence of double adenomas can pose diagnostic and management challenges and is a common cause of surgical failure. Intraoperative evaluation is important in the identification of double or multiple pituitary adenomas in a patient presenting with multiple secretory manifestations.

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Author Biographies

Wei Hang Kang, Universiti Tunku Abdul Rahman

Hospital Canselor Tuanku Muhriz, Malaysia

Ida Ilyani Adam, Ministry of Health Malaysia

Hospital Canselor Tuanku Muhriz, Malaysia

Norasyikin A. Wahab, National University of Malaysia

Faculty of Medicine, Universiti Kebangsaan Malaysia

Hospital Canselor Tuanku Muhriz, Malaysia

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