Pituitary gonadotroph adenomas are common but very rarely do they secrete biologically active luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There have been case studies reporting high sex hormones (testosterone/estrogen) in the presence of high or normal LH and FSH.
Here we report two cases who presented with visual disturbance and headache at a tertiary care hospital, Karachi, Pakistan. Brain imaging of both patients revealed a pituitary macroadenoma. Hornonal workup of our patients is shown below.
Hormonal workup of case 1 and case 2
Figure Legend: FSH, Follicle stimulating hormone; FT4, Free Thyroxine; LH, luteinizing hormone; MIU/ml, milli-international units per milliliter; ng/dl, nanogram per deciliter; ug/dl, microgram per deciliter; GH, Growth hormone; Both patients underwent transsphenoidal resection of the tumor and tissue histopathology confirmed pituitary adenoma. Postoperatively, improvement in hormonal profile was observed along with the resolution of visual disturbances and headaches.
|Case 1||Case 2||
Thus, functional gonadotroph adenoma should be considered in the presence of elevated testosterone/estrogen and normal or elevated follicle-stimulating hormone (FSH)/ luteinizing hormone (LH). Early diagnosis leads to a better outcome.
Keyword: Pituitary Neoplasms, Gonadotrophs, Follicle Stimulating Hormone, Luteinizing Hormone, Adenoma, Testosterone
22 May 2021 - 26 May 2021