Clinical, Radiological, and Histopathological Characteristics of a Patient with a Pituitary Tumor of the Corticotrophinoma Type — Case Report

Abstract

Introduction. Cushing disease is a rare but severe endocrine disorder. It is caused by a pituitary tumor producing excessive amounts of adrenocorticotropic hormone (ACTH) which is subsequently responsible for excessive production of cortisol in the adrenal glands. Hypercortisolism manifests with many symptoms and disorders that affect numerous organs.
 Aim. To increase knowledge among nursing staff about the symptoms, causes, and treatment of patients with Cushing disease.
 Case Report. A 40-year-old patient with a history of infertility treatment was admitted to the Clinical Department of Neurosurgery of St. Raphael Hospital in Krakow due to a pituitary tumor. For 7 years the patient had been experiencing symptoms such as weight gain, excessive tiredness, and menstrual disorders. The MRI examination of the pituitary showed a tumor in the sella turcica with dimensions of 4.5×5.5×4.5 mm. The histopathological examination revealed corticotropic pituitary adenoma (positive for ACTH). The patient underwent surgery after which symptoms of hypercortisolism decreased and menstruation returned. The patient became pregnant and gave birth to a child.
 Discussion. A proper diagnosis in this patient’s case could protect her from development of many complications related to other organs, such as diabetes mellitus or hypertension.
 Conclusions. Cushing disease remains in some cases undiagnosed for many years. The patient is being referred to various specialists (ophthalmologist, gynecologist, rheumatologist) due to symptoms that are in fact complications of hypercortisolism. The case illustrates the importance of early recognition of the main symptoms of hypercortisolism. Such clinical skill would undeniably help to refer the patient to the appropriate specialist, i.e., an endocrinologist much earlier, and thus establish the correct diagnosis and implement appropriate treatment. (JNNN 2023;12(3):134–139)