Zusammenfassung
Wir berichten über den Fall eines 19-jährigen Patienten, der trotz normaler Testosteronspiegel klinische Zeichen eines Hypogonadismus aufwies. In der weiterführenden Diagnostik zeigte sich das Bild eines Panhypopituitarismus infolge eines β-HCG-produzierenden, intrazerebral metastasierten suprasellären Germinoms. Aufgrund der paraneoplastischen Produktion von β-HCG bestand trotz gonadotroper Insuffizienz eine ausreichende Stimulation der Leydigschen Zwischenzellen mit normalen Testosteronspiegeln, was zu einer teilweisen Maskierung der gonadotropen Insuffizienz geführt hatte. Der Patient wurde mittels einer kombinierten Radiochemotherapie behandelt und ist seit über 7 Jahren rezidivfrei.
Abstract
We report on a 19 year old patient with clinical signs of hypogonadism (small testicles, missing pollutions and diminished beard growth) despite of normal testosterone levels. Further diagnostic procedures revealed panhypopituitarism with insufficiency of the gonadotrope, somatotrope and corticotrope axis due to a β-HCG-producing suprasellar germinoma with intracerebral metastases. Paraneoplastic production of β-HCG resulted in sufficient stimulation of Leydig cells with normal production of testosterone, which had partly masked clinical symptoms of gonatrope insufficiency. The patient was treated by combined radiochemotherapy and is in remission since 7 years.
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Bauditz, J., Ventz, M., van Landeghem, F. et al. Hypogonadismus bei einem jungen Mann mit normalen Testosteronspiegeln. Internist 46, 334–340 (2005). https://doi.org/10.1007/s00108-004-1326-0
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DOI: https://doi.org/10.1007/s00108-004-1326-0