{"entity":{"id":"gonadotroph-pitnet","kind":"cancer","name":"Gonadotroph pituitary neuroendocrine tumour (non-functioning adenoma)","aka":["Gonadotroph tumour","Gonadotroph tumour (most non-functioning adenomas)","Gonadotroph adenoma","Non-functioning pituitary adenoma (most are gonadotroph)","SF1-lineage PitNET","Null cell adenoma (many reclassified as gonadotroph)"],"tldr":"A gonadotroph tumour is a pituitary tumour of the cells that normally make the fertility hormones, but it almost never secretes enough to cause symptoms, so it is found as a large non-functioning mass pressing on the optic nerves or by chance. Surgery through the nose is the treatment when it threatens vision or grows; there is no drug for it, and radiotherapy is used for regrowth.","summary":"The 2022 WHO classification places the gonadotroph tumour in the SF1 lineage, defined by SF1, GATA3 and oestrogen receptor alpha with variable FSH and LH staining, and it accounts for most tumours previously called non-functioning or null cell adenomas (Asa 2022). Gonadotroph adenomas often present as invasive macroadenomas not amenable to complete resection; radiotherapy is the only postoperative option for large invasive or recurrent lesions, no medical treatment is available, and the somatostatin analogues that target SSTR2 have little effect, which prompted the study of SSTR3 expression in 108 patients as a possible target (Endocrine-Related Cancer 2015). Gonadotroph tumours carry a heavier CD68-positive M2 macrophage infiltrate than somatotroph, lactotroph or corticotroph tumours, linked to invasion (JCEM 2020).\n\nHow it differs from its parent: it is the pituitary tumour without a hormone syndrome or a drug, managed by observation, surgery for mass effects and radiotherapy for regrowth; its risk is to vision and to the remaining pituitary function.\n\nHow common: the commonest non-functioning pituitary tumour; no separate incidence figure in the sources read.\n\nTreatment: observation with MRI and visual fields for incidental tumours away from the optic chiasm; transsphenoidal surgery for visual compromise, growth or pituitary failure; radiotherapy or radiosurgery for residual or recurrent tumour; hormone replacement for hypopituitarism; temozolomide for the rare aggressive tumour, as on the parent page.","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Pituitary_adenoma","links":[{"label":"NCI PDQ: pituitary tumours treatment","url":"https://www.cancer.gov/types/pituitary/treatment"},{"label":"Asa 2022, Endocrine Pathology: overview of the 2022 WHO classification of pituitary tumours","url":"https://doi.org/10.1007/s12022-022-09703-7"},{"label":"Endocrine-Related Cancer 2015: SSTR3 as a target for the medical treatment of gonadotroph adenomas, 108 patients","url":"https://doi.org/10.1530/erc-14-0472"},{"label":"JCEM 2020: immune landscape of pituitary tumours, macrophages and gonadotroph tumour invasion","url":"https://doi.org/10.1210/clinem/dgaa520"}],"tags":["subtype-page","wave4","rare"],"related":["pituitary-tumours","lactotroph-pitnet","corticotroph-pitnet","thyrotroph-pitnet","craniopharyngioma"],"cancers":[],"sections":[],"technologies":["radiosurgery-srs"],"targets":[],"drugs":["temozolomide"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"endocrine","burden":"The commonest non-functioning pituitary tumour; the SSTR3 study assembled 108 patients from one pathology cohort (Endocrine-Related Cancer 2015). GLOBOCAN does not count pituitary tumours.","subtypes":["Gonadotroph pituitary tumour presenting as a non-functioning macroadenoma (the usual form)","Incidental gonadotroph microadenoma (observation)","Gonadotroph tumour with clinically apparent FSH or LH excess (rare; ovarian hyperstimulation)","Aggressive or recurrent gonadotroph tumour (radiotherapy, temozolomide)"],"biomarkers":["SF1, GATA3 and oestrogen receptor alpha lineage markers; FSH and LH immunostaining","Visual fields and optic chiasm contact on MRI","Anterior pituitary hormone panel for hypopituitarism","Ki-67 and invasion (recurrence risk)"],"standardOfCare":[{"setting":"Incidental, away from the chiasm","approach":"Observation with MRI and visual fields.","refs":["pituitary-tumours"]},{"setting":"Visual compromise, growth or recurrence","approach":"Transsphenoidal surgery; radiotherapy or radiosurgery for residual or recurrent tumour; temozolomide for aggressive tumours.","refs":["radiosurgery-srs","temozolomide","pituitary-tumours"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"pituitary-tumours"},"route":"/cancers/gonadotroph-pitnet/","neighbours":{"cancer":[{"id":"corticotroph-pitnet","kind":"cancer","name":"Corticotroph pituitary neuroendocrine tumour (Cushing disease and silent corticotroph tumour)","route":"/cancers/corticotroph-pitnet/"},{"id":"craniopharyngioma","kind":"cancer","name":"Craniopharyngioma","route":"/cancers/craniopharyngioma/"},{"id":"lactotroph-pitnet","kind":"cancer","name":"Lactotroph pituitary neuroendocrine tumour (prolactinoma)","route":"/cancers/lactotroph-pitnet/"},{"id":"pituitary-tumours","kind":"cancer","name":"Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma","route":"/cancers/pituitary-tumours/"},{"id":"somatotroph-pitnet","kind":"cancer","name":"Somatotroph pituitary neuroendocrine tumour (acromegaly)","route":"/cancers/somatotroph-pitnet/"},{"id":"thyrotroph-pitnet","kind":"cancer","name":"Thyrotroph pituitary neuroendocrine tumour (TSH-secreting)","route":"/cancers/thyrotroph-pitnet/"}],"technology":[{"id":"radiosurgery-srs","kind":"technology","name":"Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)","route":"/technologies/radiosurgery-srs/"}],"drug":[{"id":"temozolomide","kind":"drug","name":"Temozolomide","route":"/drugs/temozolomide/"}]}}