Gonadotropin secreting pituitary microadenoma

FSH and LH secreting pituitary adenomas may not be as rare as has been previously thought. Women in their reproductive years with a normal estrogenic state and hypergonadotropic amenorrhea should be suspected to harbor a pituitary microadenoma secreting gonadotropins. A computerized tomogram of the pituitary confirms the diagnosis. Two such cases who underwent transphenoidal resection of their adenomas are presented. Pituitary dynamic testing is normal in both. Laparoscopic directed ovarian biopsies show primordial follicles in one and a corpus luteum in the other. Transphenoidal resection, with the risk of permanent hypopituitarism, should be weighed against expectant management, with periodic evaluation of pituitary functions, until the natural history of these adenomas is uncovered.