Silent Crooke’s cell corticotroph adenoma of the pituitary gland presenting as delayed puberty
Corticotroph adenomas are extremely rare in children and adolescents. We present a 15-year-old boy who was investigated for delayed puberty (A1P2G1, bilateral testicular volumes of 3 mL each). There was no clinical or laboratory evidence suggestive of chronic illness, and the initial clinical impr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2017-03-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0153 |
| Summary: | Corticotroph adenomas are extremely rare in children and adolescents. We present a 15-year-old boy who was
investigated for delayed puberty (A1P2G1, bilateral testicular volumes of 3 mL each). There was no clinical or laboratory
evidence suggestive of chronic illness, and the initial clinical impression was constitutional delay in puberty. Subsequently,
MRI scan of the brain revealed the presence of a mixed cystic and solid pituitary lesion slightly displacing the optic
chiasma. The lesion was removed by transphenoidal surgery and the biopsy confirmed the lesion to be pituitary adenoma.
Furthermore, the adenoma cells also had Crooke’s hyaline changes and were intensely positive for ACTH. However there
was no clinical/biochemical evidence of ACTH excess. There was a spontaneous pubertal progression twelve months after
the surgery (A2P4G4, with bilateral testicular volume of 8 mL). Crooke’s cell adenoma is an extremely rare and aggressive
variant of corticotroph adenoma that can uncommonly present as a silent corticotroph adenoma in adults. We report for
the first time Crooke’s cell adenoma in an adolescent boy presenting with delayed puberty. |
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| ISSN: | 2052-0573 2052-0573 |