Pituitary Enlargement Secondary to Untreated Primary Hypogonadism

A patient with isolated primary hypogonadism is presented in whom documented sella enlargement occurred over a 25-year period during which androgen replacement therapy was withheld. Similar less adequately documented case reports are summarized, and the experimental literature is reviewed. The possibility of pituitary enlargement secondary to hyperplasia or pituitary tumor induction in such patients as a result of failure to provide adequate replacement therapy is discussed.