Abstract
Clinically non-functional pituitary adenomas are often derived from gonadotropin producing cells. However, gonadotropinomas causing elevated serum levels of follicle-stimulating hormone (FSH) and clinical signs of FSH hypersecretion are very rarely described. Our patient, a 56-year-old man, was referred to our clinic with signs of hypogonadism. Magnetic resonance imaging (MRI) and biochemical examinations showed a large pituitary adenoma and excessive levels of serum FSH. Clinical examination and ultrasound measurement revealed bilaterally enlarged testes. After pituitary surgery, serum FSH levels normalized and there was a decrease in testicular volume. This case suggests that supraphysiological levels of FSH from a gonadotropinoma can cause a clinically observable effect, i.e. testicular enlargement. This is in line with experimental studies showing biological effect of FSH from pituitary adenomas and previous occasional reports of ovarian hyperstimulation and testicular enlargement in patients with FSH-secreting gonadotropinomas.
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Abbreviations
- ACTH:
-
Corticotropin
- FSH:
-
Follicle-stimulating hormone
- GH:
-
Growth hormone
- LH:
-
Luteinizing hormone
- MRI:
-
Magnetic resonance imaging
- SHBG:
-
Sex hormone-binding globulin
- TSH:
-
Thyroid stimulating hormone
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Acknowledgements
The authors wish to express their gratefulness to Dr. Ann Wigelius at the department of Radiology for performing the ultrasound measurements and Dr. Göran Brattsand at the department of Clinical Chemistry for discussions and details regarding serum hormone analyses. This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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Dahlqvist, P., Koskinen, LO.D., Brännström, T. et al. Testicular enlargement in a patient with a FSH-secreting pituitary adenoma. Endocr 37, 289–293 (2010). https://doi.org/10.1007/s12020-009-9302-z
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DOI: https://doi.org/10.1007/s12020-009-9302-z