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This version published online on November 2, 2004
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1373
A more recent version of this article appeared on January 1, 2005
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Submitted on July 15, 2004
Accepted on September 28, 2004

CLINICAL CASE SEMINAR GONADOTROPH TUMOR ASSOCIATED WITH MEN1

Maria Benito, Sylvia L. Asa, Virginia A. LiVolsi, Valerie A. West, and Peter J. Snyder*

Departments of Medicineand Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Christiana Hospital, Newark, DE

Although anterior pituitary tumors constitute a main clinical feature of multiple endocrine neoplasia type 1 (MEN1), and most types of pituitary tumors have been associated with MEN1, gonadotroph tumors have not previously been recognized clinically as part of this syndrome. We report here a woman who presented with ovarian hyperstimulation due to a gonadotroph tumor that was confirmed biochemically and immunohistochemically. She then developed hyperparathyroidism, and she was found to have three hypercellular parathyroid glands. Subsequently she developed a temporal lobe metastasis of the gonadotroph tumor, demonstrating that it was a gonadotroph carcinoma. The diagnosis of MEN1 was confirmed by finding a deletion mutation (c.307delC) on the second exon of the MEN1 gene that predicts truncation of the resulting menin protein fifteen codons downstream from the deletion (p.Leu103fsX15). This case illustrates that gonadotroph tumors, like other pituitary tumors, can be part of MEN1. The clinical implications of this case are that the clinical and biochemical features of gonadotroph tumors should be considered when evaluating patients for MEN1, and MEN1 should be considered in patients who have gonadotroph tumors.


Key words: Gonadotroph adenoma • gonadotroph carcinoma • MEN1 • hyperparathyroidism







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