Isolated gonadotropin deficiency with primary empty sella: Causal or casual association?

Empty sella is a radiological-anatomical entity characterised by a sella turcica filled partially or completely with cerebrospinal fluid, leading to varying degrees of pituitary flattening. Literature reports a 5% 20% incidence of empty sella in unselected autopsies leading many to argue that it is an extreme normal variant. Endocrine dysfunction varies from 8% 25% with primary empty sella and growth hormone deficiency is most common. However isolated gonadotropin deficiency with normal sized primary empty sella is rare if any. We are reporting a case of isolated gonadotropin deficiency with primary empty sella unable to confirm or refute the association as causal or casual.