XXXX After Treatment of Nonfunctional @entity977 : A Case Report and Literature Review.

@entity1 @entity4545 @entity227 @entity41 @entity5 @entity229 @entity1955 @entity699 @entity4923 @entity977 @entity701 @entity652
We describe a very rare case of nonfunctional @entity977 (NFPA) that exhibited corticotrophic activity after resection and radiotherapy. The possible mechanisms of the transformation from NFPA to @entity4923 ( @entity4923 ) are discussed.A 43-year-old @entity1 presented with @entity227 , and hyposexuality. He had no symptoms suggestive of @entity699 , and 8am plasma @entity701 concentration was 67.88ng/mL. Brain imaging revealed a 15*15*21-mm sellar mass suggestive of a macroadenoma. The @entity5 was resected by transsphenoidal surgery and identified by immunohistochemical analysis as a chromophobic @entity652 that did not stain for pituitary hormones. The @entity1 was treated with @entity229 and @entity1955 replacement therapy. After a third recurrence, the @entity1 presented with clinical features and physical signs of @entity699 . Plasma @entity4545 ( @entity4545 ) and @entity701 concentrations were elevated, and there was a loss of circadian rhythms. Inferior petrosal sinus sampling after desmopressin showed the central-peripheral @entity4545 ratio was greater than 3:1. A repeat transsphenoidal resection was undertaken. Immunohistochemistry revealed @entity4545 positivity. Three months following surgery, imaging @entity41 , but plasma @entity4545 remained elevated. He was referred for postoperative Gamma Knife radiotherapy.The immunological activity and biological features of the hormones secreted from a @entity977 vary with time. Because long-term outcomes are unpredictable, postoperative follow-up is essential to detect postoperative transformation from NFPA to @entity4923 .
