ECE2021 Eposter Presentations Pituitary and Neuroendocrinology (32 abstracts)
Functional pituitary gonadotroph adenoma in male patients: a case study
Nanik Ram 1 , Sajjad Ali Khan 1 , Bhagwan Das 2 & Najmul Islam 1
1Aga Khan University Hospital, Department of Medicine, Section of Diabetes Mellitus, Metabolism and Endocrinology, Karachi, Pakistan; 2Cancer Foundation Hospital, Karachi, Pakistan
Background
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.
Case presentation
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.
| Laboratory Parameters |
Case 1 | Case 2 | Normal values |
||
| Pre- Surgery |
Post- Surgery |
Pre- Surgery |
Post- Surgery |
||
| FSH | 36.66 | 4.97 | 13.61 | 1.4–15.4#160;MIU/ml | |
| LH | 7.09 | 0.99 | 4.45 | 1.2–7.8#160;MIU/ml | |
| Testosterone | 952.7 | 176.8 | > 1500 | 20.14 | 193–740#160;ng/dl |
| Cortisol | 2.60 | 7.40 | 12.60 | 11.10 | 4.3–22.4#160;ng/dl |
| FT4 | 0.69 | 1.65 | 0.84 | 0.88 | 0.89–1.76#160;ng/dl |
| Prolactin | 12.40 | 36.80 | 3–14.7#160;ng/ml | ||
| GH | < 0.50 | 0.06 | 0.13 | 2.0–5.0#160;ng/ml | |
Conclusion
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
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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