Zárate A, Fonseca M E, Mason M, Tapia R, Miranda R, Kovacs K, Schally A V
Acta Endocrinol (Copenh). 1986 Sep;113(1):29-34. doi: 10.1530/acta.0.1130029.
Hypersecretion of both FSH and LH was demonstrated in a man with pituitary macroadenoma, who also presented elevated levels of blood testosterone and an increased sperm count. The patient underwent transsphenoidal surgery followed immediately by cranial irradiation. Immunocytochemical analysis of the tumour revealed the presence of FSH, LH, TSH and the alpha-subunit. Gel chromatography of the serum on Sephadex G-100 revealed immunoactive FSH, LH and the alpha-subunit which coeluted with the labelled standards of corresponding hormones. Blood levels of both gonadotropins and testosterone remained persistently elevated up to one year following surgical decompression of the tumour and radiotherapy. It was decided to treat this patient with sc administration of 100 micrograms D-Trp6-LRH biweekly. After 20 weeks, LRH-analogue treatment resulted in the reduction of serum FSH and LH levels and a diminishing in tumour size as assessed by computed tomography scan of the pituitary. This report shows that in a patient with clinically and biochemically documented gonadotropin-secreting adenoma, inducing a state of persistent gonadal hyperfunction, pituitary surgery and cranial irradiation failed to normalize the biochemical abnormality; however, therapy with D-Trp6-LRH agonist induced clinical, biochemical and radiologic improvement.
一名患有垂体大腺瘤的男性被证明促卵泡生成素（FSH）和促黄体生成素（LH）分泌过多，其血液睾酮水平升高且精子数量增加。该患者接受了经蝶窦手术，随后立即进行了头部放疗。对肿瘤的免疫细胞化学分析显示存在FSH、LH、促甲状腺激素（TSH）和α亚基。血清在葡聚糖凝胶G - 100上进行凝胶过滤，显示免疫活性FSH、LH和α亚基与相应激素的标记标准品共洗脱。在肿瘤手术减压和放疗后长达一年的时间里，两种促性腺激素和睾酮的血液水平持续升高。决定对该患者每两周皮下注射100微克D - 色氨酸6 - 促性腺激素释放激素（LRH）进行治疗。20周后，LRH类似物治疗导致血清FSH和LH水平降低，并且通过垂体计算机断层扫描评估肿瘤大小减小。本报告表明，在一名临床和生化记录为促性腺激素分泌性腺瘤、导致持续性性腺功能亢进状态的患者中，垂体手术和头部放疗未能使生化异常恢复正常；然而，D - 色氨酸6 - LRH激动剂治疗诱导了临床、生化和放射学改善。
