Non-functioning pituitary tumour after long-term treatment with gonadotrophin-releasing hormone agonists in a patient with vaginal agenesis who underwent neovaginoplasty and cauterization of endometriosis under laparoscopy

Vaginal agenesis combined with a functional uterus is a rare condition in w hich treatment modalities that preserve reproductive function are controver sial. A 21 year old female presented with congenital vaginal agenesis combi ned with cervical atresia. She was treated with gonadotrophin-releasing hor mone (GnRH) agonists for a total period of over 5 years when a non-function ing pituitary tumour was detected by brain magnetic resonance imaging (MRI) , A laparoscopically assisted reconstruction of a neovagina and neoendocerv ical canal was performed utilizing lyophilized porcine dermal skin to line the neovagina. Endometriosis of the pelvis was revealed and adhesiolysis an d cauterization were also carried out under laparoscopy. The GnRH agonist w as discontinued and the patient resumed cyclic menses with no abdominal pai n. The pituitary tumour decreased in size 6 months after the cessation of G nRH agonists. We raise the question as to whether pituitary MRI should be p erformed for patients who need long-term administration of GnRH agonists.