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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
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.
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).
How 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.
| Setting | Approach | Guideline |
|---|---|---|
| Incidental, away from the chiasm | Observation with MRI and visual fields. | not mapped |
| Visual compromise, growth or recurrence | Transsphenoidal surgery; radiotherapy or radiosurgery for residual or recurrent tumour; temozolomide for aggressive tumours. | not mapped |