From the Guidelines
LH and FSH secreting tumors are characterized by an abnormal LH/FSH ratio >2 and elevated serum levels of LH >11 IU/l and FSH >35 IU/l 1.
Key Characteristics
- Hormonal Imbalance: These tumors can lead to hormonal imbalances, including hypersecretion of luteinising hormone and hypofunction of the follicle stimulating hormone (FSH)–granulosa cell axis 1.
- Clinical Presentation: Patients may present with symptoms such as irregular periods, hirsutism, and hyperandrogenism 1.
- Diagnostic Criteria: Diagnosis is based on measurement of serum LH and FSH levels, with abnormal findings including an LH/FSH ratio >2 and elevated serum levels of LH >11 IU/l and FSH >35 IU/l 1.
Associated Conditions
- Polycystic Ovary Syndrome (PCOS): LH and FSH secreting tumors can be associated with PCOS, a form of hyperandrogenic chronic anovulation 1.
- Pituitary Adenomas: These tumors are a type of rare pituitary adenoma that can lead to hormonal imbalances 1.
Important Considerations
- Treatment Options: Treatment options may include surgical resection, dopamine agonists, and somatostatin analogs 1.
- Individualized Treatment: Treatment duration and approach should be individualized based on clinical response and tumor size 1.
From the Research
Characteristics of LH and FSH Secreting Tumors
- LH-secreting pituitary adenomas are rare, with most gonadotropin-secreting pituitary adenomas secreting both LH and FSH or only FSH 2, 3
- FSH-secreting pituitary adenomas can cause clinical symptoms such as ovarian hyperstimulation, fibromatosis, and menstrual irregularities in women 4
- In men, functional pituitary gonadotroph adenomas can present with elevated testosterone levels and normal or elevated LH and FSH levels 5
- Clinically non-functioning pituitary adenomas (NFPAs) are common, but most do not secrete biologically active LH and FSH, and are often found incidentally or diagnosed based on compressive symptoms 6
Biochemical Characteristics
- Elevated LH and alpha-subunit levels have been observed in patients with LH-secreting pituitary adenomas 2
- Elevated FSH levels, often with suppressed LH levels, have been observed in patients with FSH-secreting pituitary adenomas 4
- Elevated testosterone levels, with normal or elevated LH and FSH levels, have been observed in men with functional pituitary gonadotroph adenomas 5
Clinical Presentation
- Precocious puberty has been reported in rare cases of LH-secreting pituitary adenomas 3
- Ovarian hyperstimulation, fibromatosis, and menstrual irregularities have been reported in women with FSH-secreting pituitary adenomas 4
- Visual disturbances and headaches are common presenting symptoms of pituitary adenomas, including those that secrete LH and FSH 5, 6