Endocrine Abstracts (2001) 2 P71


M Coculescu1,2, C Badiu1,2, A Caragheorgheopol2, M Gheorghiu1,2, IL Gussi1, S Radian1, R Rotarus2, R Carnu2, C Rasanu1 & R Braga1

1Department of Endocrinology, 'Carol Davila' University, Bucharest, Romania; 2'CI Parhon' Institute of Endocrinology, Bucharest, Romania.

There are difficulties in establishing the diagnosis of gonadotropinomas using serum hormonal levels, even after intravenous TRH. We evaluated the relationship between humoral (serum and cerebrospinal fluid - CSF) levels of gonadotropins and the immunohistochemical evidence in tumor tissue.

Serum and CSF levels of pituitary hormones were assayed using rapid fluoroimmunometry with Europium. Immunohistochemistry (IHC) was performed with avidin-biotine. Group A (gonadotropinomas, FSH -positive) had 20 patients (13 female, 7 male), aged 28 - 68 yrs; 8 showed over 30% FSH-positive cells (+++). The control group C had 35 patients (19 female, 16 men), aged 22 - 60 yrs, with pituitary adenomas IHC-negative for FSH. Transfrontal and transsphenoidal surgery was performed after CT/MRI localisation. Only 2/20 gonadotropinomas showed high serum levels of FSH (VE female, 44 yrs: 81.2 IU/L; BI male, 35 yrs: 18.0 IU/L), decreasing after surgery. In 3/4 women with gonadotropinomas at the age of menopause, FSH serum levels were less than in healthy women. In group A (n=14, without the mentioned exceptions) FSH serum level was 2.93 plus/minus 0.8 (mean plus/minus standard error of the mean), range 0.5 - 9.6, similar with the control group (n=19) 2.83 plus/minus 0.73 IU/L, and CSF levels were respectively 3.54 plus/minus 1.64 (range 0.26 - 24.03) and 2.36 plus/minus 0.96 IU/L. Only in gonadotropinomas the mean CSF levels of FSH were above serum levels. This is more evident in the 8 cases intensely FSH positive (+++), where CSF FSH is 5.13 plus/minus 2.8 IU/L, and serum levels only 3.26 plus/minus1.22. The evaluation of LH is not so clear. In conclusion FSH ratio between CSF and serum is suggestive for the presence of FSH positive adenomas.

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