Vol 69, No 5 (2018)
Original paper
Published online: 2018-08-03

open access

Page views 2361
Article views/downloads 1103
Get Citation

Connect on Social Media

Connect on Social Media

Blood serum concentrations of gonadotropins and α-subunit in patients with gonadotropinomas in relation to the immunoreactivity of pituitary adenoma

Marek Pawlikowski (Łódź)1, Maria Jaranowska2, Jolanta Fryczak1, Maciej Radek3, Jacek Świętosławski2, Jolanta Kunert-Radek4, Katarzyna Winczyk2
Pubmed: 30074232
Endokrynol Pol 2018;69(5):526-529.


Introduction: Although active gonadotropin-secreting pituitary adenomas are considered very rare, the vast majority of pituitary tumours diagnosed as “non-functioning” express gonadotropins or their free β or α subunits. However, systemic investigations comparing the serum concentrations of follitropin (FSH), lutropin (LH), and α–subunit (αSU) before surgery with the immunoreactivity of the respective substances in the excised tumours are still lacking.

Material and methods: Immunostaining of FSH, LH, and αSU was compared in 43 surgically removed gonadotropin — expressing pitu­itary adenomas with serum concentrations of the above-mentioned substances before surgery in the same patients.

Results: The serum concentrations of FSH were elevated (> 11.6 mU/mL) in 8/12 (66.7%) cases of FSH-positive adenomas. By contrast, in FSH–negative tumours the elevation of FSH is absent. Moreover, only 1/25 (4%) patients with LH–positive adenoma had the elevated serum concentration of LH (51.5 mU/mL). The overproduction of LH was not observed in adenomas expressing free β LH or in LH-negative tumours. In patients with αSU-positive adenomas elevated serum levels of αSU were observed in 3/15 (20%) cases. No αSU elevations were observed in patients with αSU–negative adenomas. The mean serum FSH, LH, and αSU concentrations were higher in patients with FSH, LH, and/or αSU immunopositive tumours in comparison with immunonegative. However, the differences are not statistically significant.

Conclusions: Although “silent” gonadotropinomas constitute a frequent subtype of pituitary adenomas, the “active” subtype (i.e. manifesting by gonadotropin excess) are rare (approx. 4% of all pituitary adenomas). Gonadotropinomas are difficult to diagnose before surgery. The measurement of gonadotropins including αSU is needed but often not sufficient for presurgical diagnosis.

Article available in PDF format

View PDF Download PDF file


  1. Snyder P. Gonadotroph cell adenomas of the pituitary. Endocrine Rev. 1985; 6(4): 552–563.
  2. Halupczok J, Bidzińska-Speichert B, Lenarcik-Kabza A, et al. Gonadotroph adenoma causing ovarian hyperstimulation syndrome in a premenopausal woman. Gynecol Endocrinol. 2014; 30(11): 774–777.
  3. Dahlqvist P, Koskinen LOD, Brännström T, et al. Testicular enlargement in a patient with a FSH-secreting pituitary adenoma. Endocrine. 2010; 37(2): 289–293.
  4. Trouillas J, Girod C, Sassolas G, et al. La cellule gonadotrope humaine normale et tumorale. Ann Endocrinol. 1990; 51: 54–64.
  5. Pawlikowski M, Kunert-Radek J, Radek A. Gonadotropinoma — a frequent subtype of the pituitary adenoma. Endokrynol Pol. 2000; 51: 77–81.
  6. Kunert-Radek J, Radek A, Gruszka A, et al. Immunohistochemical investigation of clinically nonfunctioning pituitary tumors as a prognostic factor of tumor recurrence. Proceedings of 12th Int Congress of Endocrinology. Lisbon. 31.VIII - 4.IX 2004: Medimond.
  7. Kontogeorgos G. Classification and pathology of pituitary tumors. Endocrine. 2005; 28(1): 27–35.
  8. Pawlikowski M. Immunohistochemistry of pituitary tumours — clinical references [in polish]. Folia Medica Lodzensia. 2007; 34: 5–19.
  9. Raverot G, Jouanneau E, Trouillas J. Management of endocrine disease: clinicopathological classification and molecular markers of pituitary tumours for personalized therapeutic strategies. Eur J Endocrinol. 2014; 170(4): R121–R132.
  10. Snyder PJ. Gonadotroph cell pituitary adenomas. Endocrinol Metab Clin North Am. 1987; 16(3): 755–764.
  11. Chanson P, Brochier S. Non-functioning pituitary adenomas. J Endocrinol Invest. 2005; 28(11 Suppl International): 93–99.
  12. Gruszka A, Kunert-Radek J, Pawlikowski M. Serum alpha-subunit elevation after TRH administration: a valuable test in presurgical diagnosis of gonadotropinoma? Endokrynol Pol. 2005; 56(1): 14–18.
  13. Estepa A, Dastis M, Alia P, et al. Utility of alpha subunit determination after thyrotropin-releasing hormone stimulation as an indicator of gonadotropinoma persistence and/or recurrence. Endocrinol Nutr. 2008; 55(6): 253–258.