case_images: PMC10783686_01
case_images: (a) Magnetic resonance imaging (MRI) coronal section preoperative brain MRI reveals a macro pituitary neuroendocrine tumor (PitNET) (30 x 27 x 25 mm). (b) MRI sagittal section preoperative brain MRI reveals a macro PitNET (30 x 27 x 25 mm).
case_images: SNI-14-425-g001.jpg
case_images: PMC10783686_01_SNI-14-425-g001.jpg
case_images: F1
case_images: Computed tomography and magnetic resonance imaging (MRI) scans revealed a macro PitNET (30 x 27 x 25 mm) [Figure 1]. The micro PitNET was successfully removed with a second EES [Figure 4], and both endocrinological and pathological examinations confirmed the cure [Figure 5 and Table 1].
case_images: (a) Magnetic resonance imaging (MRI) coronal section postoperative MRI reveals a complete removal of the macro pituitary neuroendocrine tumor (PitNET) and the residual micro PitNET (arrow) in the left thin, normal pituitary gland. (b) MRI sagittal section postoperative MRI reveals a complete removal of the macro PitNET.
case_images: SNI-14-425-g002.jpg
case_images: PMC10783686_01_SNI-14-425-g002.jpg
case_images: F2
case_images: Although postoperative MRI showed complete tumor removal [Figure 2], endocrinological examination detected no improvement in GH or IGF-1 levels. Therefore, we re-examined the MRI findings and found a micro PitNET (2.4 x 2 x 1.5 mm) in the left thin, normal pituitary gland [Figure 2].
case_images: (a) Steroidogenic factor-1 (SF-1)-positive image immunohistochemical staining of the first surgical specimen shows positive staining for SF-1, follicle-stimulating hormone (FSH), and alpha-subunit, indicating that the resected tumor is a gonadotroph pituitary neuroendocrine tumor (PitNET), (b) FSH-positive image immunohistochemical staining of the first surgical specimen shows positive staining for SF-1, FSH, and alpha-subunit, indicating that the resected tumor is a gonadotroph PitNET, (c) alpha-subunit-positive image immunohistochemical staining of the first surgical specimen shows positive staining for SF-1, FSH, and alpha-subunit, indicating that the resected tumor is a gonadotroph PitNET.
case_images: SNI-14-425-g003.jpg
case_images: PMC10783686_01_SNI-14-425-g003.jpg
case_images: F3
case_images: Pathological examination of the surgical specimen revealed a gonadotropic PitNET [Figure 3].
case_images: (a) Magnetic resonance imaging (MRI) coronal section MRI after the second operation shows the complete removal of the residual micro pituitary neuroendocrine tumor (PitNET) in the left thin, normal pituitary gland, (b) MRI sagittal section MRI after second operation shows the complete removal of the residual micro PitNET in the left thin, normal pituitary gland.
case_images: SNI-14-425-g004.jpg
case_images: PMC10783686_01_SNI-14-425-g004.jpg
case_images: F4
case_images: The micro PitNET was successfully removed with a second EES [Figure 4], and both endocrinological and pathological examinations confirmed the cure [Figure 5 and Table 1].
case_images: (a) Growth hormone (GH)-Positive Image Immunohistochemical staining of the 2nd surgical specimen exhibits positive staining for GH, somatostatin receptor type 2 (SSTR-2), POU1F1/GHF-1(Pit-1), and alpha-subunit, which mean that the resected tumor is a somatotroph pituitary neuroendocrine tumor (PitNET), (b) SSTR2-positive image immunohistochemical staining of the 2nd surgical specimen exhibits positive staining for GH, SSTR-2, Pit-1, and alpha-subunit, which mean that the resected tumor is a somatotroph PitNET, (c) Pit-1-positive Image Immunohistochemical staining of the 2nd surgical specimen exhibits positive staining for GH, SSTR-2, Pit-1, and alpha-subunit, which mean that the resected tumor is a somatotroph PitNET, (d) alpha-subunit-Positive Image Immunohistochemical staining of the 2nd surgical specimen exhibits positive staining for GH, SSTR-2, Pit-1, and alpha-subunit, which mean that the resected tumor is a somatotroph PitNET.
case_images: SNI-14-425-g005.jpg
case_images: PMC10783686_01_SNI-14-425-g005.jpg
case_images: F5
case_images: The micro PitNET was successfully removed with a second EES [Figure 4], and both endocrinological and pathological examinations confirmed the cure [Figure 5 and Table 1].