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A Journal on Internal Medicine

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Panminerva Medica 2000 December;42(4):237-40

language: English

Gonadotroph cell pituitary adenomas in males

Manieri C., Di Bisceglie C., Razzore P., Fornengo R., Papotti M. *, Isolato G. **, Ciccarelli E.

From the ­UODU Endo­crin­o­lo­gia Dipar­ti­men­to di Med­i­ci­na Inter­na
*Dipar­ti­men­to di ­Scienze Bio­me­diche e Onco­lo­gia Uma­na
**Dipar­ti­men­to di Dis­ci­pline Med­i­co-Chi­rur­giche Sez­i­one di ­Scienze Radio­lo­giche Università ­degli Stu­di di Tori­no, Tori­no, Ita­ly


Back­ground. Con­sid­ered excep­tion­al in the ­past, gonad­o­troph ­cell pitui­tary aden­o­mas ­account for 3.5-6.4% of ­total sur­gi­cal­ly ­excised pitui­tary aden­o­mas ­when exam­ined ­with immu­nos­pe­cif­ic stain­ing. The aim of ­this ­study was to ­describe the clin­i­cal, hor­mo­nal, radio­log­i­cal and immu­no­his­to­chem­i­cal fea­tures, the man­age­ment and the fol­low-up of our ­patients ­with gonad­o­troph aden­o­ma.
Meth­ods. In ­this ret­ro­spec­tive ­study we ­describe 14 ­male sub­jects ­aged 19-70 yrs affect­ed by gonad­o­troph ­cell pitui­tary aden­o­mas; the ­patients ­were stud­ied by hor­mo­nal, radio­log­i­cal and immu­no­his­to­chem­i­cal inves­ti­ga­tions and fol­lowed up for 3-13 yrs by ambu­la­to­ry and/or hos­pi­tal­ized ­care.
­Results. Vis­u­al impair­ment and/or ­decreased libi­do and erec­tile dys­func­tion ­were the symp­toms at pres­en­ta­tion. ­Increased ser­um gon­a­dot­ro­pin con­cen­tra­tions ­were ­shown in 3 ­patients. ­Reduced lev­els of tes­tos­te­rone ­were ­present in 9 ­patients, and nor­mal in the remain­der. At diag­no­sis all ­patients had pitui­tary mac­ro­aden­o­mas, ­with ­wide extra­sel­lar exten­sion in 12. All ­patients under­went trans­-sphe­noid­al sur­gery and immu­no­his­to­chem­i­cal stain­ing of sur­gi­cal­ly ­excised spec­i­mens ­showed the pres­ence of gonad­o­troph and α-sub­unit ­cells in all pitui­tary aden­o­mas. ­After sur­gery 3 ­patients had ­clear radio­log­i­cal evi­dence of nor­mal pitui­tary; in the oth­ers a doubt­ful MRI pic­ture or a resid­u­al ade­nom­a­tous tis­sue ­were ­present. In the ­patients who did not under­go radio­ther­a­py imme­di­ate­ly ­after sur­gery, a ­regrowth of tumo­ral tis­sue was ­shown in 1-10 yrs.
Con­clu­sions. We ­stress the impor­tance of a ­close fol­low-up of ­patients ­with gonad­o­troph aden­o­mas ­after sur­gery, and we ­raise the ques­tion of wheth­er radio­ther­a­py may be use­ful for avoid­ing any fur­ther ade­nom­a­tous ­regrowth.

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