Pituitary Macroadenoma May be a Tentative Diagnosis in a Young Patient With Anemia

A 25-year-old young man presented to our emergency room with a 3-month history of progressive headache and being easily tired. The familial and personal history of the patient was not significant. On examination, he appeared generally weak. The neurological examination revealed no visual defects, decreased muscle power, or other neurological deficits. Laboratory studies showed normocytic anemia with serum hemoglobin 12.7 g/dL. Magnetic resonance imaging (MRI) of brain was performed, which disclosed a 1.9 cm sellar mass that caused compression and mild elevation of the optic chiasm. The diagnosis of pituitary macroadenoma was established. Therefore, navigator-assisted endoscopic transnasal transsphenoidal approach to remove the tumor was performed and postoperative recovery was uneventful. A definitive diagnosis of a gonadotroph adenoma is made by pathologic evaluation of the tumor. We emphasize that pituitary adenoma should be a tentative diagnosis in a male patient with normocytic and normochromic anemia with hypogonadism. The anemia is associated with hypogonadism and tumor size, and improves following treatment that increases testosterone level. Headache may be the only neurological sign.