@article{oai:ycu.repo.nii.ac.jp:00001988,
 author = {石川　, 駿 and 中村　, 大志 and 宇高, 直子 and 松本, 修太朗 and 末永, 潤 and 清水, 信行 and 伊藤, 譲 and 山本, 哲哉},
 issue = {1},
 journal = {横浜医学, Yokohama　Medical 　Journal},
 month = {Jan},
 note = {Excess secretion of growth hormone （GH） causes acromegaly, which is associated with increased morbidity and mortality. Primary GH hypersecretion from pituitary adenomas （PAs） is the most common cause of acromegaly, but sometimes microadenomas （<10 mm） cannot be detected by magnetic resonance imaging （MRI） of the head, resulting in delayed treatment by surgical resection. In this study, selective catheter hormone sampling of the venous sinus provided evidence of the localization of GH-secreting PAs. 　A 47-year-old male, admitted to a previous hospital due to a hypertensive right thalamic hemorrhage, was incidentally suspected of acromegaly due to his physiological findings. Acromegaly is diagnosed by a combination of enlarged extremities and extremely high serum levels of GH and insulin-like growth factor-1 （IGF-1）. A GH-secreting microadenoma was suspected by repetitive MRIs and selective intravenous hormone sampling in the head, resulting in left-side dominant high serum levels of GH. In an endoscopic trans-sphenoidal surgery （TSS）, the tumor was first apparent on the right side inside the normal pituitary gland, but we followed the lesion based on the results of the catheter examination. The tumor stretched to the left side and attached to the medial wall of the left cavernous sinus. The tumorous lesion was resected, and this was confirmed by a postoperative MRI and peripheral serum GH/IGF-1 level measurement. Serum GH and IGF-1 levels decreased at 108 days after surgical resection. Pathological diagnosis resulted in the observation of a sparsely granulated GHsecreting PA. 　There are often cases where it is difficult to diagnose acromegaly with localization of the pathological lesion. The reason is that more than 50% of GH-secreting PAs are <10 mm, making it difficult to visualize the tumor in imaging examinations. 　Here, we diagnosed a GH-secreting PA in a patient who received TSS and subsequently regained normal serum GH/IGF-1 levels.},
 pages = {13--16},
 title = {Efficacy of intravenous catheter hormone sampling  for growth hormone-secreting pituitary adenoma: a case report},
 volume = {71},
 year = {2020},
 yomi = {イシカワ, シュン and ナカムラ, タイシ and ウダカ, ナオコ and マツモト, シュウタロウ and スエナガ, ジュン and シミズ, ノブユキ and イトウ, ユズル and ヤマモト, テツヤ}
}