April - June 2008, Volume 4, Issue 2

Gheorghiu ML, Niculescu D, Dumitrascu A, Coculescu M

Pituitary stone in long-standing acromegaly with spontaneous remission

Acta Endo (Buc) 2008, 4 (2): 203-210
doi: 10.4183/aeb.2008.203

A 51 years old woman, diagnosed 23 years ago with acromegaly and non-insulin dependent diabetes mellitus, who denied radical treatment and took bromocriptine 2.5 - 7.5 mg/day sporadically and oral antidiabetic drugs, presented with chronic headaches, acromegalic features, bilateral temporal hemianopia, hypertension, hyperglycemia. Her pituitary function was normal (random serum growth hormone 2.5 - 2.8 ng/mL). The skull X-ray showed an enlarged sella turcica, with blurred multiple contour and an „egg-shell” calcification boarding the interior sellar floor. Cranial CT scan revealed a 1.7/0.7 cm intrasellar macrocalcification with a low-density core, lying on most of the sellar floor. In addition there were partial empty sella, asymmetrical optic chiasm, multiple cerebral,\r\nvascular and pineal microcalcifications, but no visible pituitary or tumor mass. Apoplexy within a previous large pituitary growth hormone-secreting tumor, followed by resorption and peripheral calcification, may have produced this rare case of pituitary stone associated with remission of acromegaly and sequelar visual field defect.

Keywords: pituitary, calcification, acromegaly, diabetes mellitus

Correspondence: Prof. Dr. Mihail Coculescu, Department of Endocrinology, “Carol Davila” University, 34-36 Aviatorilor Blvd, 011863 Bucharest, Romania, e-mail: m.coculescu@uni-davila.ro