title: A silent follicle-stimulating hormone-producing pituitary adenoma in a teenage male.
abstract: An 18-year-old male was referred to Toranomon Hospital seeking reoperation for recurrent clinically nonfunctioning pituitary adenoma. A pituitary macroadenoma was first suspected at age 15 due to intractable headaches. Endocrine data were unremarkable except slightly elevated serum follicle-stimulating hormone (FSH). Transsphenoidal surgery done at another hospital achieved partial tumor removal but the remaining tumor regrew 2 years after surgery. The recurrent tumor was completely and selectively removed on repeat surgery at Toranomon Hospital. Pathological examination confirmed a silent FSH-producing pituitary adenoma. Forty-five patients less than 20 years old underwent transsphenoidal surgery for pituitary adenoma at Toranomon Hospital between 1993 and 2010. Of the 45 patients, 36 (80.0%) had clinically functioning adenomas and the other 9 (20.0%) had clinically non-functioning adenomas. No patients, other than the present case, had a silent gonadotroph adenoma. In contrast, among 579 patients over 20 years old undergoing surgery for nonfunctioning pituitary adenomas between 2006 and 2010 at Toranomon Hospital, 304 (52.3%) had silent gonadotroph adenomas. Gonadotroph adenomas are more common with aging: for example, 37 (61.7%) of 60 patients more than 70 years old at the time of operation had gonadotroph adenomas. In conclusion, gonadotroph adenomas, especially silent gonadotroph adenomas, are extremely rare in childhood and adolescence.
authors.affiliation: Department of Endocrinology, Toranomon Hospital, Toranomon 2-2-2, Minato, Tokyo, 105-8470, Japan. tamiyatky@gmail.com
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tamiya
authors.forename: Noriaki
authors.initials: N
authors.lastname: Fukuhara
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
authors.forename: Hisanori
authors.initials: H
authors.lastname: Suzuki
authors.forename: Akira
authors.initials: A
authors.lastname: Takeshita
authors.forename: Naoko
authors.initials: N
authors.lastname: Inoshita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishioka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sano
authors.forename: Shozo
authors.initials: S
authors.lastname: Yamada
mesh_terms: D000293:Adolescent; D005640:Follicle Stimulating Hormone / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D010911:Pituitary Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D005640:Follicle Stimulating Hormone