{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:18:54Z","timestamp":1740136734073,"version":"3.37.3"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Silent corticotroph adenoma (SCA) is as an aggressive pituitary tumor. A 48 year old man developed hypogonadotrophic hypogonadism. The basal morning adrenocorticotropic hormone (ACTH) was elevated, but the basal morning and peak after ACTH (1\u201324) stimulation cortisol were normal. A 3.7 cm sellar mass with evidence of internal hemorrhage, encasement of the right internal carotid artery, and invasion of the right cavernous sinus were identified, resected, and stained positive for ACTH. Over the next 5 years, the basal morning ACTH and cortisol were normal, and imaging revealed the presence of a small residual tumor. One year later, the patient became fatigued and nauseated, with elevated ACTH. An overnight metyrapone stimulation test (OMST) revealed glucocorticoid insufficiency, without further increase in ACTH. Symptoms resolved with hydrocortisone treatment. This case study suggests that SCA can secrete an ACTH precursor that is detected by clinical assays but is not active biologically. Postoperative OMST reveals glucocorticoid insufficiency in this context.<\/jats:p>","DOI":"10.1093\/labmed\/lmab053","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T11:26:05Z","timestamp":1620818765000},"page":"91-94","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Glucocorticoid Insufficiency in Silent Corticotroph Adenoma with Elevated Adrenocorticotropic Hormone"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4060-2252","authenticated-orcid":false,"given":"Amnon","family":"Schlegel","sequence":"first","affiliation":[{"name":"Endocrine Section, Medicine Service, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, UT, US"},{"name":"Department of Internal Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Utah School of Medicine, Salt Lake City, Utah, US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"issue":"4","key":"2022010903452613800_CIT0001","first-page":"1039","article-title":"Recurrence of silent corticotroph adenomas after primary treatment: a systematic review and meta-analysis","volume":"104","author":"Fountas","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2022010903452613800_CIT0002","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1227\/01.neu.0000429858.96652.1e","article-title":"A comprehensive long-term retrospective analysis of silent corticotrophic adenomas vs hormone-negative adenomas","volume":"73","author":"Jahangiri","year":"2013","journal-title":"Neurosurgery."},{"issue":"1","key":"2022010903452613800_CIT0003","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s11102-017-0844-4","article-title":"Predictors of silent corticotroph adenoma recurrence; a large retrospective 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