A 58-year-old male with a pituitary adenoma was investigated and demonstrated to have hypersecretion of both gonadotropins in the basal state. Presenting symptoms included visual disturbance, headache, loss of libido, impotence, cold intolerance
and
urinary frequency. The patient denied alteration of hair distribution and did not disclosed the acral features, galactorrhea or gynecomastia. Dynamic assay with synthetic thyrotropin-releasing hormone and synthetic gonadotropin-releasing hormone
result
in increase of serum luteininzing hormone (LH) and follicle stimulation hormone (FSH). Immunochemically, tumor cell revealed positive reaction forchromogranin and FSH, but negative for LH. Electron microscopic examination using paraffin embedded
block
was failed to demonstrate classic neurosecretory granule, but some electron dense granules were found in the cytoplasm. Gonadotropin-producing pituitary adenomas are rare, but have been diagnosed more frequently as radiographic techniques and
biochemical assays have improved. A review of the literatures documents pituitary tumor secreting both FSH and LH in the basal state and we report a case of gonadotropin-producing pituitary adenoma.
|