Meyer A C, Papadimitriou J C, Silverberg S G, Sharara F I
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore 21201, USA.
Fertil Steril. 2000 Feb;73(2):258-60. doi: 10.1016/s0015-0282(99)00511-7.
To report a case of secondary amenorrhea and infertility caused by an inhibin-B-producing ovarian fibrothecoma.
Case report.
Academic medical center.
A 37-year-old woman with a 2-year history of secondary amenorrhea and infertility.
INTERVENTION(S): Operative removal of a 5-cm ovarian fibrothecoma.
MAIN OUTCOME MEASURE(S): Luteinizing hormone, FSH, E2, inhibin-B, TSH, and prolactin measured preoperatively and postoperatively. Immunostaining of tumor cells for inhibin and LH.
RESULT(S): Preoperative hormone levels were as follows: FSH, 1.7 mIU/mL; LH, 23.4 mIU/mL; E2, 31 pg/mL; and inhibin B, 1,154 pg/mL. Three weeks postoperatively, the FSH was 1.5 mIU/mL, LH decreased to 7.1 mIU/mL, E2 increased to 276 pg/mL, and inhibin-B decreased to 17 pg/mL. The fibrothecoma did not stain for LH but was strongly positive for inhibin. Regular menstrual cycles resumed 28 days postoperatively.
CONCLUSION(S): Inhibin-B produced by an ovarian tumor profoundly suppressed FSH levels and resulted in secondary amenorrhea and infertility. Use of sensitive and specific immunoassays for inhibin-A and -B may aid in the differential diagnosis of hormonally active ovarian tumors.
报告一例由分泌抑制素B的卵巢纤维瘤引起的继发性闭经和不孕病例。
病例报告。
学术医疗中心。
一名37岁女性，有2年继发性闭经和不孕病史。
手术切除一个5厘米的卵巢纤维瘤。
术前和术后测定促黄体生成素、卵泡刺激素、雌二醇、抑制素B、促甲状腺激素和催乳素。对肿瘤细胞进行抑制素和促黄体生成素免疫染色。
术前激素水平如下：卵泡刺激素1.7 mIU/mL；促黄体生成素23.4 mIU/mL；雌二醇31 pg/mL；抑制素B 1154 pg/mL。术后3周，卵泡刺激素为1.5 mIU/mL，促黄体生成素降至7.1 mIU/mL，雌二醇升至276 pg/mL，抑制素B降至17 pg/mL。纤维瘤对促黄体生成素无染色，但对抑制素有强阳性染色。术后28天月经周期恢复正常。
卵巢肿瘤产生的抑制素B可显著抑制卵泡刺激素水平，导致继发性闭经和不孕。使用针对抑制素A和B的敏感且特异的免疫测定法可能有助于对具有激素活性的卵巢肿瘤进行鉴别诊断。
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