Gonadotroph cell pituitary adenomas in males

Background. Considered exceptional in the past, gonadotroph cell pituitary adenomas account for 3.5-6.4% of total surgically excised pituitary adenoma s when examined with immunospecific staining. The aim of this study was to describe the clinical, hormonal, radiological and immunohistochemical featu res, the management and the follow-up of our patients with gonadotroph aden oma, Methods. In this retrospective study we describe 14 male subjects aged 19-7 0 yrs affected by gonadotroph cell pituitary adenomas; the patients were st udied by hormonal, radiological and immunohistochemical investigations and followed up for 3-13 yrs by ambulatory and/or hospitalized care. Results. Visual impairment and/or decreased libido and erectile dysfunction were the symptoms at presentation. Increased serum gonadotropin concentrat ions were shown in 3 patients. Reduced levels of testosterone were present in 9 patients, and normal in the remainder. At diagnosis all patients had p ituitary macroadenomas, with wide extrasellar extension in 12. All patients underwent trans-sphenoidal surgery and immunohistochemical staining of sur gically excised specimens showed the presence of gonadotroph and alpha -sub unit cells in all pituitary adenomas, After surgery 3 patients had clear ra diological evidence of normal pituitary; in the others a doubtful MRT pictu re or a residual adenomatous tissue were present, In the patients who did n ot undergo radiotherapy immediately after surgery, a regrowth of tumoral ti ssue was shown in 1-10 yrs, Conclusions. We stress the importance of a close follow-up of patients with gonadotroph adenomas after surgery, and we raise the question of whether r adiotherapy may be useful for avoiding any further adenomatous regrowth.