A case of gonadotropinoma with polycysts as remnants of Rathke's cleft

摘要

Context. This is a case of gonadotropinoma presented with Rathke's cleft cyst. Objective. We are presenting a case of gonadotropinoma along with Rathke's cleft cyst which is unique case as being male and symptomatic gonadotropin releasing adenoma. Method. A 51 year old man was referred to our institution for evaluation of impotence and loss of libido. His endocrine screening evaluations revealed hypopituitarism with low levels of blood cortisol and ACTH, and high levels of prolactin. Results. An endonasal transsphenoidal endoscopic approach was performed and upon inspection via endoscope the floor of sella was eroded and following dural incision soft dark colored tumor overflowed through sella. Pathology revealed gonadotropinoma with unexpected remnants of Rathke's cleft cyst. Conclusion. Pituitary adenomas and Rathke's cleft cysts have a common embryologic ancestry. Our case was a symptomatic gonadotropinoma consisting of multicystic component which was then demonstrated as Rathke's cleft cyst in pathological work up. This combination may be the result of a coincidence or Rathke's cleft cysts may be the origin of the pituitary adenomas.