Cryptorchidism is a Useful Clue for Idiopathic Hypogonadotropic Hypogonadism in Pituitary Stalk Thickening

Keywords: hypopituitarism, cryptorchidism, hypogonadism, pituitary disease


Pituitary stalk lesions can represent a wide range of pathologies. The exact cause is often unknown due to hesitancy to proceed with biopsy. We present a 16-year-old adolescent who presented with delayed puberty, short stature and bilateral cryptorchidism. He was found to have a thickened pituitary stalk of uncertain etiology with partial hypopituitarism (gonadotrophin and growth hormone deficiency) on further assessment. The presence of bilateral cryptorchidism and micropenis represents lack of “mini puberty,” a phenomenon of activation of the hypothalamic - pituitary-gonadal (HPG) axis in -utero or within the first few months of life.1 These key clinical features have been useful to establish an early temporal relationship and suggest a congenital origin of disease. This enabled a more conservative approach of surveillance to be employed as opposed to invasive pathological examination with pituitary stalk biopsy.


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Author Biographies

Shamharini Nagaratnam, University Kebangsaan Malaysia Medical Centre

Endocrine Fellow

Subashini Rajoo, Hospital Kuala Lumpur

Consultant Physician and Endocrinologist

Mohamed Badrulnizam Long Bidin , Hospital Kuala Lumpur

Consultant Physician and Endocrinologist

Norzaini Rose Mohd Zain, Hospital Kuala Lumpur

Consultant Neuroradiologist


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How to Cite
Nagaratnam, S., Rajoo, S., Long Bidin , M. B., & Mohd Zain, N. R. (2021). Cryptorchidism is a Useful Clue for Idiopathic Hypogonadotropic Hypogonadism in Pituitary Stalk Thickening. Journal of the ASEAN Federation of Endocrine Societies, 36(1). Retrieved from
Case Reports