男性更年期症状を呈し低ゴナドトロピン性性腺機能低下症と診断された1例

概要

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A 59-year-old male was referred to our hospital with chief complaints of general fatigue and muscle stiffness of the shoulders. His hormonal data were total testosterone 0.05 ng/ml (normal: 2.01-7.5 ng/ml), free testosterone less than 0.6 pg/ml, leuteinizing hormone (LH) 1.1 mIU/ml (2.2-8.4 mIU/ml), follicle stimulating hormone (FSH) 2.4 mIU/ml (1.8-12 mIU/ml) and prolactin (PRL) 13.1 ng/ml (4.3-13.7 ng/ml). Though both his genital stage and pubic hair stage were Tanner V, his testis volume was 12 ml on the right and 10 ml on the left. A gonadotropin releasing hormone (GnRH) stimulation test revealed low responses of LH and FSH. Magnetic resonance imaging of the head revealed pituitary tumor (15 mm). Our diagnosis was acquired hypogonadtropic-hypogonadism-related pituitary tumor. Transsphenoidal hypophysectomy was performed and pathological diagnosis revealed epidermoid cyst. Three months after the operation, his total testosterone was elevated to 1.17 ng/ml and his complaints were improved.