Gonadotroph adenomas

In recent decades gonadotroph adenomas of the pituitary have been recognize d to be more common than previously thought. As they rarely result in a spe cific clinical syndrome distinct from nonfunctional adenomas, they are usua lly not discovered until large enough to cause mass-related neurologic or e ndocrine effects. Visual impairment is the most common and most significant manifestation of these tumors, with headaches and hypopituitarism also occ urring frequently. Preoperative diagnosis involves the use of MRI, and the interpretation of basal and TRH-stimulated gonadotropin patterns, although definitive diagnosis often awaits immunohistochemical study of resected tis sue. Transsphenoidal surgery is the primary mode of therapy for gonadotroph adenomas. Radiotherapy, especially stereotactic radiosurgery, may also hav e a role. Medical therapy has been disappointing to date.