Clinically nonfunctioning and gonadotroph pituitary adenomas

This thesis deals with clinically nonfunctioning, ,a-subunit secreting and gonadotroph pituitary adenomas. From the literature discussed in the preceding chapter several questions arise. Below these questions are listed with a reference to where the subject concerned was mentioned or discussed in the preceding chapter, as well as with a reference to the chapter where these questions will be discussed in detail. 1. (1.2.5) Do all clinically nonfunctioning pituitary adenomas release gonadotropins and their subunits in vitro? (4,5,6) 2. (1.2.5) Can the hormone release from clinically nonfunctioning adenomas in vitro be suppressed and stimulated with hormones and drugs? (5,6) 3. ( 1. 2. 3, 1. 2. 5) Is the secretory activity of clinically nonfunctioning, a-subunit secreting, and gonadotroph adenomas better reflected in results from cell culture than in results from immunocytochemistry? (6) 4. (1.2.1,1.2.5) Are clinically nonfunctioning, a-subunit secreting, and gonadotroph pituitary adenomas to be regarded as one group? (5,6) 5. (1.2.4} Is the exaggerated response in serum gonadotropin levels to TRH limited to patients with a gonadotroph adenoma? (5) 6. (1. 2. 6) can bromocriptine significantly suppress serum gonadotropin and a-subunit concentrations in patients with a clinically nonfunctioning adenoma and will these patients benefit from prolonged treatment with bromocriptine? (5,8) 7. (1.1.2,1.2.2) By analogy with the findings in aging men, do serum estradiol concentrations decrease and gonadotropin levels increase in aging postmenopausal women? (7) 8. (1.2.6) Can GnRH analogs be beneficial in patients with gonadotroph pituitary adenomas? (8) 9. Which drugs are promising in the future treatment of gonadotroph, a-subunit secreting, and clinically nonfunctioning pituitary adenomas? (8) The major subjects discussed in the various chapters are listed below: An introduction to the literature on clinically nonfunctioning, a-subunit secreting and gonadotroph pituitary adenomas was given in Chapter 1. The presenting symptoms of these adenomas and some in vivo data are discussed in Chapter 3. confounding factors in the· in vitro research of these adenomas are analyzed in Chapter 4. The correlations between in vivo and in vitro hormone data, effects of TRH and bromocriptine, and similarities between gonadotroph and clinically nonfunctioning adenomas are discussed in Chapter 5. Additional in vitro data are presented in Chapter 6. The etiology of clinically nonfunctioning and gonadotroph adenomas is discussed in the light of the age-dependent changes in gonadotropin and sex steroid levels in normal subjects in Chapter 7. The role of 2 drugs that might be useful in the therapy of clinically nonfunctioning, a-subunit secreting and gonadotroph pituitary adenomas is discussed in Chapter a. A discussion of the major conclusions of this thesis is presented in Chapter 9