Endocrine Abstracts

Introduction: The pituitary adenoma is the most frequent begnin pituitary tumor. They are labeled based on their size, tumors smaller than 1 cm called microadenomas and tumors bigger than 1 cm called macroadenomas. Moreover, they can be functional or non functional. Among the functional ones, gonadotroph adenomas represent 15 to 20%.

Observation

We report the case of a 27 years old women, who consulted for secondary amenorrhea for 1 year. Further hormonal examinations showed an elevated FSH level at 170 mUI/l and an elevated LH level at 81 mUI/l with no other abnormalities in the rest of the pituitary hormones.The MRI revealed a macroadenoma 11.5 × 12.4 mm in diameter strongly enhanced with gadolinium-based contrast agents.After a few years of surveillance, the patient developed a visual field deficit and a decrease in the visual acuity. She underwent lesional resection by the endonasal transsphenoidal approach complicated with panhypopituitarism.The analysis of the tumor samples revealed an immunopositivity for both FSH and LH.

Conclusion: In women, functional gonadotroph adenomas may cause ovarian stimulation syndrome and/or menstrual abnormalities. They are mostly macroadenomas and are associated with significant morbidity.The primary therapy remains surgical which can lead sometimes to full recovery.