Gonadotroph Adenomas. A Single-Center Study of 112 cases.
M. Solovey*a (Mrs), M. Gukb (Dr), O. Danevychb (Dr), A. Chukovb (Mrs)
a Komisarenko Endocrinology and Metabolism Institut, Romodanov Neurosurgery Institute, Kyiv, UKRAINE ; b Romodanov Neurosurgery Institute, Kyiv, UKRAINE
Background. Gonadotroph adenomas are the most common type of clinically nonfunctioning pituitary adenomas (NFAs), totally silent in the most cases. Clinical presentation of the gonadotroph adenoma depends on its biological behaviour. There are few data regarding the age and sex prevalence of gonadotroph adenomas and clinical data correlations.
Objective. To discover age and sex prevalence of gonadotroph adenomas and the differences in clinical presentation according to the immunohistochemical staining.
Materials and Methods. The study includes 112 cases of clinically nonfunctioning pituitary adenomas removed in our center via transnasal transsphenoidal endoscopic approach with positive immunohistochemical staining for gonadotropins and/or steroidogenic factor 1 (SF1). All patients (50 women and 62 men) have been divided into five age groups: 20-34 (A) years old, 35-44 (B) years old, 45-54 (C) years old, 55-64 (D) years old, 65-75 (E) years old. Peculiarities of immunohistochemical profile have been statistically analyzed in those age groups. Clinical presentation, imaging, laboratory hormonal data and immunohistochemical staining features have been analyzed in such groups: LH-positive, FSH-positive, LH-FSH-positive, LH-FSH-negative but SF1-positive.
Results. The prevalence of silent gonadotroph adenomas have appeared to be increased with age with predominant proportion in groups D-E in women and groups B-E in men. The incidence of visual disturbances was more frequent in men with LH- and FSH-positive adenomas than in women. There were no differences in the rate of hypopituitarism in the patients with LH- and FSH-positive adenomas. The rate of invasive gonadotropinomas was the same in LH-FSH-positive adenomas in men and in women but differed in LH- and FSH-adenomas. There were evidences of hormonal activity in some adenomas.
Conclusions. The differences among gonadotroph adenomas revealed in our study may be helpful in diagnosing and optimal treatment of NFPAs.
The author has declared no conflict of interest.