Halupczok Jowita, Kluba-Szyszka Anna, Bidzińska-Speichert Bożena, Knychalski Bartłomiej
Department of Endocrinology, Diabetology and Isotope Therapy, Wroclaw Medical University, Poland.
1st Department of General, Gastroenterological and Endocrinological Surgery, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2015 Jul-Aug;24(4):695-703. doi: 10.17219/acem/25212.
Ovarian hyperstimulation syndrome (OHSS) occurs mostly as an iatrogenic complication of assisted reproductive technology. Gonadotroph pituitary adenomas are rarely associated with OHSS. To the authors' knowledge, to date only 30 cases of spontaneous ovarian stimulation associated with gonadotroph adenomas have been reported in women and only 2 in children. The most common symptoms in such cases included menstrual disturbances, abdominal or pelvic pain, abdominal distension and increased girth. Galactorrhea, nausea and vomiting were also reported. Neurological symptoms occurred when the size of the pituitary tumor reached at least 20 mm. Transvaginal ultrasound examination usually demonstrated enlarged multicystic ovaries. MRIs of the pituitary revealed macroadenomas up to 61 mm in maximum diameter. The hormonal profiles of the reported cases showed normal or elevated FSH levels, suppressed LH levels, elevated estradiol levels and supranormal concentrations of prolactin. Transsphenoidal surgery is the therapy of choice, however other treatment modalities can be utilized in selected cases.
卵巢过度刺激综合征（OHSS）大多作为辅助生殖技术的医源性并发症出现。促性腺激素垂体腺瘤很少与OHSS相关。据作者所知，迄今为止，女性中仅有30例与促性腺激素腺瘤相关的自发性卵巢刺激病例报告，儿童中仅有2例。此类病例最常见的症状包括月经紊乱、腹部或盆腔疼痛、腹胀和腹围增加。也有溢乳、恶心和呕吐的报告。当垂体肿瘤大小至少达到20毫米时会出现神经症状。经阴道超声检查通常显示多囊卵巢增大。垂体的磁共振成像（MRI）显示最大直径达61毫米的大腺瘤。报告病例的激素谱显示卵泡刺激素（FSH）水平正常或升高、促黄体生成素（LH）水平受抑制、雌二醇水平升高以及催乳素浓度超常。经蝶窦手术是首选治疗方法，不过在特定病例中也可采用其他治疗方式。
