Hattori N, Ishihara T, Moridera K, Ikekubo K, Hino M, Saiki Y, Kurahachi H
Department of Endocrinology, Kobe City General Hospital, Japan.
Endocrinol Jpn. 1991 Aug;38(4):393-6. doi: 10.1507/endocrj1954.38.393.
Gonadotropin secreting pituitary adenomas have been reported with increasing frequency in men, but they are still rarely recognized in women. We report a 52-year-old postmenopausal woman with LH- and FSH-secreting pituitary adenoma. She had increased LH (37.0 +/- 13.7 IU/l) (mean +/- SD) and FSH (109.9 +/- 26.7 IU/l) but these concentrations were within normal ranges in 80 postmenopausal women (LH: 29.7 +/- 18.3 IU/l, FSH: 104.0 +/- 43.9 IU/l). The administration of GnRH and conjugated estrogen resulted in normal response of LH and FSH. No abnormal response of gonadotropin to TRH and bromocriptine was observed. After transsphenoidal adenomectomy both LH and FSH decreased (LH: 11.1 +/- 4.2 IU/l, FSH: 37.0 +/- 9.6 IU/l). An immunocytochemical study revealed that the adenoma cells synthesize both LH and FSH. The rarity of gonadotropin secreting pituitary adenomas in women could be the result of greater difficulty in recognition due to an increase in serum gonadotropin in postmenopausal women.
促性腺激素分泌型垂体腺瘤在男性中的报道频率越来越高，但在女性中仍很少被识别。我们报告了一名52岁的绝经后女性，患有分泌促黄体生成素（LH）和促卵泡生成素（FSH）的垂体腺瘤。她的LH（37.0±13.7IU/L）（均值±标准差）和FSH（109.9±26.7IU/L）升高，但在80名绝经后女性中这些浓度处于正常范围（LH：29.7±18.3IU/L，FSH：104.0±43.9IU/L）。给予促性腺激素释放激素（GnRH）和结合雌激素后，LH和FSH有正常反应。未观察到促性腺激素对促甲状腺激素释放激素（TRH）和溴隐亭的异常反应。经蝶窦腺瘤切除术后，LH和FSH均下降（LH：11.1±4.2IU/L，FSH：37.0±9.6IU/L）。免疫细胞化学研究显示腺瘤细胞同时合成LH和FSH。女性中促性腺激素分泌型垂体腺瘤罕见可能是由于绝经后女性血清促性腺激素升高导致识别难度增加的结果。
