FSH-produzierender Hypophysentumor bei einem 13jährigen Mädchen

Etzrodt, A.; Etzrodt, H.; Hey, O.

doi:10.1055/s-2007-1026437

Cited by 3 publications

(4 citation statements)

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“…A small volume of ascites and negative tumour markers may be useful for distinguishing benign and malignant tumours. In six cases including our patient, after surgical resection of the pituitary tumour, the enlarged ovaries spontaneously decreased in size 1,5–7,9 . Surgical excision of the ovarian cysts does not need to be performed in patients with FSH‐secreting gonadotroph adenoma.…”

Section: Discussionmentioning

confidence: 78%

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CASE REPORT: Management of ovarian hyperstimulation due to follicle‐stimulating hormone‐secreting gonadotroph adenoma

Murakami

Higashitsuji

Yoshinaga³

et al. 2004

BJOG

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Case reportA 21 year old virgin woman sought medical attention because of a history of secondary amenorrhoea for several years and abdominal distention for the previous six months. She had been receiving a cyclic oestrogen and progestin therapy, and bilateral ovarian cysts had been detected at previous clinics that she had visited.Pelvic ultrasonography and magnetic resonance imaging (MRI) showed bilateral multiple ovarian cysts over the pelvis, a small volume of ascites and a relatively thickened endometrium (Fig. 1). There was no solid portion in the cysts. The serum concentrations of tumour markers were not elevated and were as follows: CA125, 38.6 U/mL (normal 39 U/mL); CA19 -9, 27.7 U/mL ( 37 U/mL); carcinoembryonic antigen, 1.43 ng/mL ( 5 ng/mL); and a-fetoprotein, 0.80 ng/mL ( 20 ng/mL).Endocrinological examination showed that the serum oestradiol concentration was extremely high at 3998 pmol/L. The serum follicle-stimulating hormone (FSH) and prolactin (PRL) concentrations were supranormal at 10.3 IU/mL and 79.9 ng/L, respectively. Serum luteinising hormone (LH) was not detectable before and even after administration of LH-releasing hormone or thyrotropin-releasing hormone. Haemoconcentration and electrolyte abnormalities were not seen.Terguride therapy was administered and a brain MRI was planned due to mild hyperprolactinaemia and galactorrhoea. The MRI revealed a pituitary tumour. Visual field examination, which was performed after the MRI, revealed bitemporal hemianopsia. The levels of other pituitary hormones were within the normal ranges and were as follows: growth hormone (GH), 1.68 ng/mL; thyrotropinstimulating hormone (TSH), 1.05 AIU/mL; and adenocorticotropic hormone (ACTH), 36.7 pg/mL. Terguride therapy was cancelled in a week, and transsphenoidal removal of the pituitary adenoma was performed as the initial therapy. Her ovarian cysts were not treated because she did not have severe abdominal pain and there was a low possibility of malignancy. Immunohistochemical staining of the pituitary tumour for pituitary hormones revealed that the tumour cells expressed LH, FSH and PRL but not GH, TSH or ACTH. The patient was diagnosed with gonadotroph adenoma.Her post-operative course was uneventful. She had withdrawal bleeding for several days after the operation. The bilateral huge ovarian cysts dramatically decreased in size and her hormone levels of FSH, PRL, oestradiol and LH improved within one month after the operation. Other pituitary hormone levels were not influenced by the transsphenoidal surgery. Her menstrual cycle resumed, and her visual field deficits improved gradually.At 26 years of age, five years after excision of the pituitary tumour, she had no recurrent signs of gonadotroph adenoma. She conceived spontaneously during the following year. She delivered a female baby weighing 2488 g by spontaneous vaginal delivery at 37 weeks of gestation. DiscussionTen cases of FSH-secreting gonadotroph adenoma in young women have been reported to our knowledge. 1 -10 However, these reports mainly d...

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Section: Discussionmentioning

confidence: 78%

“…Ten cases of FSH‐secreting gonadotroph adenoma in young women have been reported to our knowledge 1–10 . However, these reports mainly described the endocrinological peculiarity Table 1.…”

Section: Discussionmentioning

confidence: 99%

CASE REPORT: Management of ovarian hyperstimulation due to follicle‐stimulating hormone‐secreting gonadotroph adenoma

Murakami

Higashitsuji

Yoshinaga³

et al. 2004

BJOG

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“…She reported amenorrhea after menarche [14]. The other girl was an adolescent with metrorrhagia who needed a blood transfusion due to severe anemia [15]. Pelvic ultrasound revealed bilateral enlarged ovaries with multiple cysts in both patients.…”

Section: Discussionmentioning

confidence: 99%

“…To date a total of 17 cases (2 in children) of OHSS have been published in association with follicle-stimulating hormone (FSH) or α-subunit-producing adenomas [2,3,4,5,6,7,8,9,10,11,12,13,14,15]. In those series, diagnosis of the pituitary tumor was made in most patients only after confirming benign follicular cysts at the ovarian biopsy (10/17).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Ovarian Hyperstimulation Syndrome Caused by a Follicle-Stimulating Hormone-Secreting Pituitary Macroadenoma in an Early Pubertal Girl

Gryngarten

Braslavsky²,

Ballerini³

et al. 2010

Horm Res Paediatr

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Gonadotroph adenomas are difficult to diagnose since they usually show as nonsecreting tumors or produce biologically inactive hormones with no clinical effects and classically grow silent until neurological symptoms appear. Presentation with bilateral ovarian masses and ovarian hyperstimulation has been described in fertile years. Gonadotroph adenomas are extremely infrequent in children. We report a 13-year-old postmenarcheal girl referred to our hospital with 6 months of amenorrhea, abdominal palpable mass presumptive of bilateral ovarian tumors. The patient had Tanner IV breast development and a large abdominal mass occupying the whole low hemiabdomen. Laboratory evaluation revealed high estradiol levels with suppressed luteinizing hormone and inappropriately high follicle-stimulating hormone (FSH) levels. Pelvic ultrasound showed enlarged ovaries containing multiple giant cysts. An MRI revealed a pituitary macroadenoma. Transsphenoidal resection of the adenoma was performed with an uneventful postoperative course. Immunohistologic examination only showed staining for FSH, thus confirming pituitary secreting FSH adenoma. Hormonal laboratory levels normalized and ovarian masses showed marked involution 1 month after surgery. Three months later the MRI showed tumor disappearance. Conclusion: The presence of bilateral ovarian tumors requires a careful endocrine and neurological evaluation to exclude the presence of an FSH-producing tumor in order to avoid unnecessary ovarian surgery.

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Gonadotropin secreting pituitary adenoma associated with erythrocytosis: case report and literature review

et al. 2014

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FSH-produzierender Hypophysentumor bei einem 13jährigen Mädchen

Cited by 3 publications

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CASE REPORT: Management of ovarian hyperstimulation due to follicle‐stimulating hormone‐secreting gonadotroph adenoma

CASE REPORT: Management of ovarian hyperstimulation due to follicle‐stimulating hormone‐secreting gonadotroph adenoma

Spontaneous Ovarian Hyperstimulation Syndrome Caused by a Follicle-Stimulating Hormone-Secreting Pituitary Macroadenoma in an Early Pubertal Girl

Gonadotropin secreting pituitary adenoma associated with erythrocytosis: case report and literature review

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