Cryptorchidism is a Useful Clue for Idiopathic Hypogonadotropic Hypogonadism in Pituitary Stalk Thickening

Keywords: hypopituitarism, cryptorchidism, hypogonadism, pituitary disease

Abstract

Pituitary stalk lesions can represent a wide range of pathologies. The exact cause is often unknown due to hesitancy to proceed with biopsy. We present a 16-year-old adolescent who presented with delayed puberty, short stature and bilateral cryptorchidism. He was found to have a thickened pituitary stalk of uncertain etiology with partial hypopituitarism (gonadotrophin and growth hormone deficiency) on further assessment. The presence of bilateral cryptorchidism and micropenis represents lack of “mini puberty,” a phenomenon of activation of the hypothalamic - pituitary-gonadal (HPG) axis in -utero or within the first few months of life.1 These key clinical features have been useful to establish an early temporal relationship and suggest a congenital origin of disease. This enabled a more conservative approach of surveillance to be employed as opposed to invasive pathological examination with pituitary stalk biopsy.

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Author Biographies

Shamharini Nagaratnam, Hospital Kuala Lumpur, Malaysia

Fellow, Endocrine Unit, Department of Medicine

Subashini Rajoo, Hospital Kuala Lumpur, Malaysia

Consultant Physician and Endocrinologist, Endocrine Unit, Department of Medicine

Mohamed Badrulnizam Long Bidin , Hospital Kuala Lumpur, Malaysia

Consultant Physician and Endocrinologist, Endocrine Unit, Department of Medicine

Norzaini Rose Mohd Zain, Hospital Kuala Lumpur, Malaysia

Consultant Neuroradiologist, Department of Radiology

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Published
2021-04-23
How to Cite
Nagaratnam, S., Rajoo, S., Long Bidin , M. B., & Mohd Zain, N. R. (2021). Cryptorchidism is a Useful Clue for Idiopathic Hypogonadotropic Hypogonadism in Pituitary Stalk Thickening. Journal of the ASEAN Federation of Endocrine Societies, 36(1), 95-97. https://doi.org/10.15605/jafes.036.01.09
Section
Case Reports