Functioning Gonadotroph Adenoma with Secondary Hypersecretion of Testosterone

Introduction: Gonadotroph adenomas are generally nonfunctioning. Hypersecretion of gonadotropins by gonadotroph adenomas rarely induced hypersecretion of testosterone. We report a case of functioning gonadotroph adenoma with secondary hypersecretion of testosterone. Medical Observation: A 25-year-old patient who having had a progressive and bilateral loss of visual acuity for two years. The ophtalmologist’s examination concluded to bitemporal hemianopia. He had no other clinical manifestations of hyper or hypo hormonal secretion. The brain scan has revealed an intrasellar mass with suprasellar development that represses the optic chiasma and the carotids. The assessment carried out revealed an increase in FSH, LH and testosterone. The diagnosis of a functioning gonadotroph macroadenoma with secondary hypersecretion of testosterone was retained. Surgical excision of the adenoma was performed. Anatomo-pathological examination concluded to a pituitary adenoma. The patient showed an improvement in the right visual acuity and developed an adrenal corticotropic insufficiency substituted by hydrocortisone 20 mg per day. The postoperative hormonal profile revealed a normalization of FSH and testosterone. Conclusion: Functioning gonadotroph adenoma with secondary hypersecretion of testosterone is rare. The first-line treatment is surgical and allows an improvement of the cerebral tumor syndrome and the restoration of the gonadotropic function.