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分泌促卵泡激素的垂体腺瘤:一例病例报告及文献复习

FOLLICLE-STIMULATING HORMONE-PRODUCING PITUITARY ADENOMA: A CASE REPORT AND REVIEW OF THE LITERATURE.

作者信息

Patel Sonal, Pacione Donato, Fischer Ilene, Maloku Ekrem, Agrawal Nidhi

出版信息

AACE Clin Case Rep. 2019 Apr 25;5(3):e175-e180. doi: 10.4158/ACCR-2018-0454. eCollection 2019 May-Jun.

Abstract

OBJECTIVE

To describe an unusual presentation of a follicle-stimulating hormone-secreting pituitary adenoma leading to ovarian hyperstimulation syndrome. We also discuss the pathophysiology and subsequent management of these tumors.

METHODS

This is a case report and review of the literature. A 37-year-old female with menorrhagia was found to have bilateral multilocular adnexal cysts with concern for ovarian hyperstimulation syndrome.

RESULTS

Labs revealed elevated follicle-stimulating hormone, and an eminent estradiol level. Pituitary magnetic resonance imaging revealed a macroadenoma with cavernous sinus invasion. The patient went on to have a successful transsphenoidal resection with normalization of hormones and subsequent resumption of menstrual cycles.

CONCLUSION

With the help of this case report, we illustrate the pathogenesis of functioning gonadotroph adenomas as well as the management challenges associated with these tumors. Our case is unique in its presentation with severe hyperestrogenemia and cavernous sinus invasion pointing towards a clinically aggressive adenoma. It is important to increase awareness of these tumors to ensure timely and effective management of their complications.

摘要

目的

描述一例导致卵巢过度刺激综合征的分泌促卵泡生成素垂体腺瘤的罕见表现。我们还将讨论这些肿瘤的病理生理学及后续治疗。

方法

这是一篇病例报告及文献综述。一名37岁月经过多的女性被发现双侧附件有多房性囊肿,疑似卵巢过度刺激综合征。

结果

实验室检查显示促卵泡生成素升高,雌二醇水平显著升高。垂体磁共振成像显示有侵袭海绵窦的大腺瘤。该患者成功接受经蝶窦切除术,激素水平恢复正常,随后月经周期恢复。

结论

通过本病例报告,我们阐述了功能性促性腺激素腺瘤的发病机制以及与这些肿瘤相关的治疗挑战。我们的病例表现独特,有严重的高雌激素血症且侵袭海绵窦,提示为临床侵袭性腺瘤。提高对这些肿瘤的认识对于确保及时有效处理其并发症很重要。

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