XXXX with @entity4089 developed after bilateral adrenalectomy in a @entity1 with @entity699 due to @entity4383 .

@entity1 @entity4089 @entity2847 @entity6726 @entity5 @entity699 @entity4090 @entity2124 @entity2012 @entity1218 @entity17685 @entity4383 @entity977 @entity3317 @entity652 @entity2588
A 27-yr-old @entity1 was referred for evaluation of @entity2012 and @entity4089 . She had undergone left adrenalectomy at 12 and right adrenalectomy at 17 for @entity699 due to @entity4383 . At this time a @entity977 was found by brain computerized tomography, but plasma levels of @entity2124 ( @entity2124 ), @entity4090 (PRL) and @entity3317 (ACTH) were normal. When she was 23, symptoms and signs of @entity2012 and subsequently @entity6726 - @entity2588 had developed. Plasma @entity2124 and PRL were increased and she was followed up by the administration of @entity2847 (2.5 mg-12.5 mg/day, p.o.). However the plasma @entity2124 level had been increasing gradually. On admission, plasma @entity2124 and PRL were high (19.5 micrograms/L, 61.0 micrograms/L, respectively) and increased in response to @entity17685 ( @entity1218 , 500 micrograms i.v.). An intrasella mass, which had been detected when she was 17, had become enlarged and was removed by Hardy's operation. Microscopically, the resected @entity5 was an @entity652 . Immunohistochemical studies showed @entity2124 , PRL and ACTH positive cells localized in the @entity5 . Immunoultrastructural analysis of the @entity5 confirmed that @entity2124 , PRL and ACTH were present in secretory granules and Golgi apparatus in the @entity5 cells. The @entity1 was a rare case of @entity2012 with @entity4089 developed after bilateral adrenalectomy of @entity699 due to @entity4383 , all of which manifestations may be caused by a @entity2124 , PRL and ACTH secreting @entity977 .
