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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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Volume 30, Issue 2


Turner syndrome and pituitary adenomas: a case report and review of literature

Tiffany Yeh
  • Department of Pediatrics, Rhode Island Hospital/Hasbro Children’s Hospital, Providence, RI, USA
  • Department of Medicine, Rhode Island Hospital, Providence, RI, USA
  • The Warren Alpert Medical School of Brown University, Rhode Island, Providence, RI, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Angela Ganan Soto / Jose Bernardo Quintos
  • The Warren Alpert Medical School of Brown University, Rhode Island, Providence, RI, USA
  • Division of Pediatric Endocrinology, Rhode Island Hospital/Hasbro Children’s Hospital, Providence, RI, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lisa Swartz Topor
  • Corresponding author
  • The Warren Alpert Medical School of Brown University, Rhode Island, Providence, RI, USA
  • Division of Pediatric Endocrinology, Rhode Island Hospital/Hasbro Children’s Hospital, Providence, RI, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-01-18 | DOI: https://doi.org/10.1515/jpem-2016-0202



Turner syndrome (TS) is the most common sex chromosome abnormality in females, typically associated with primary amenorrhea and premature ovarian failure due to gonadal dysgenesis. The association of TS with hypopituitarism is an uncommon finding. The objective of the study was to describe an adolescent with TS with hypergonadotropic hypogonadism and subsequent hypogonadotropic hypogonadism.

Case presentation:

A 16-year-old female with primary amenorrhea was diagnosed with TS based on karyotype 45,XO. Other laboratory values included FSH 45.52 IU/L, LH 17.4 IU/L, undetectable estradiol, and prolactin 1.08 nmol/L. Two months later and before treatment, she presented with severe headache and a new left cranial nerve VI palsy. Brain MRI showed a 2.7-cm hemorrhagic pituitary macroadenoma expanding the sella. Laboratory evaluation showed FSH 5.9 IU/L, LH 0.9 IU/L, prolactin 0.09 nmol/L, and GH 1.03 ng/mL. She underwent transphenoidal hypophysectomy, and pathology revealed pituitary adenoma with immunohistochemical staining positive for growth hormone and prolactin. She subsequently developed multiple pituitary hormone deficiencies. Review of the literature identified eight case reports of women with TS who developed pituitary adenomas.


This case illustrates an uncommon co-occurrence of TS and pituitary macroadenoma. Sequential gonadotropin measurements demonstrate the evolution of hypergonadotropic hypogonadism into hypogonadotropic hypogonadism due to hemorrhagic pituitary macroadenoma.

Keywords: hypergonadotropic hypogonadism; hypogonadotropic hypogonadism; pituitary adenoma; Turner syndrome


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About the article

Corresponding author: Lisa Swartz Topor, MD, MMSc, Division of Pediatric Endocrinology, Rhode Island Hospital/Hasbro Children’s Hospital, 593 Eddy Street, Providence, RI 02903, USA, Phone: +401-444-5504, Fax: +401-444-2534

Received: 2016-05-20

Accepted: 2016-11-21

Published Online: 2017-01-18

Published in Print: 2017-02-01

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 30, Issue 2, Pages 231–235, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2016-0202.

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