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Exp Clin Endocrinol Diabetes 2005; 113(6): 344-349
DOI: 10.1055/s-2005-865613
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Analysis of Secretory, Immunostaining and Clinical Characteristics of Human “Functionless” Pituitary Adenomas: Transdifferentiation or Gonadotropinomas?

A. L. de Oliveira Machado1 , 2 , E. F. Adams1 , 3 , W. Schott1 , P. Nomikos1 , 2 , R. Fahlbusch1 , M. Buchfelder1 , 2
  • 1Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
  • 2Department of Neurosurgery, University of Göttingen, Göttingen, Germany
  • 3Molecular Biosciences Research Group, School of Health and Life Sciences, Aston University, Birmingham, UK
Further Information

Publication History

Received: November 11, 2004 First decision: January 25, 2005

Accepted: March 4, 2005

Publication Date:
23 June 2005 (online)

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Abstract

In this study, the central technique of in vitro culture has been used to further investigate whether LH/FSH-expressing, but clinically “functionless” pituitary adenomas are gonadotropinomas or whether their hormone secretion is due to transdifferentiation events. 664 “functionless” pituitary adenomas were examined for hormone secretion by in vitro culture and for hormone content by immunostaining. The results were correlated with the clinical findings. 40 % of the tumours (n = 263) secreted at least one of the gonadotropins alone, 8 % (n = 53) exhibited various patterns of anterior pituitary hormones, whilst the remaining 52 % of tumours were not associated with any hormone. In the secretory tumours, immunostaining revealed only a few scattered hormone-containing cells (5 to 15 %). Mild hyperprolactinaemia was observed in some cases, presumably because of pressure effects of the tumours. The majority of the patients suffered clear cut hypopituitarism (p < 0.05). Pre-operatively, gonadotropin hypersecretion was observed in 3 cases, but only one of these secreted hormones in culture. Interestingly, a higher proportion of tumours removed from patients with hypopituitarism showed secretory activity in vitro than those tumours removed from patients showing no hormonal dysfunction or hyperprolactinaemia. We conclude that the term “gonadotropinoma” to describe functionless pituitary tumours associated with LH and/or FSH secretion is a misnomer, because the presence of LH and/or FSH confirmed by in vitro methods in the present series is a result of only a few scattered cells. We suggest that primary pituitary tumour cells differentiate into a secretory type (transdifferentiation), possibly in response to altered serum hormone levels such as decreased steroids. Further work is required to identify the factors which trigger the altered cells' characteristics.

Key words

Pituitary adenoma - hypopituitarism - in vitro - gonadotrophinoma transdifferentiation

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Prof. Dr. med. M. Buchfelder

Department of Neurosurgery, University of Göttingen

Robert-Koch-Straße 40

37075 Göttingen

Germany

Phone: + 49551396033

Fax: + 49 5 51 39 87 94

Email: buchfelder@med.uni-goettingen.de

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