The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston (UTHealth®), McGovern Medical School, Houston, TX, USA.
Internal Medicine and Endocrinology, Memorial Hermann Texas Medical Center, Houston, TX, USA.
Am J Case Rep. 2020 Aug 8;21:e922797. doi: 10.12659/AJCR.922797.
BACKGROUND Few case reports exist in the literature of patients with pituitary adenoma presenting with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Complete remission of persistent PMDD symptoms after surgical removal of a pituitary lesion has not been reported. CASE REPORT We report a case of a 44-year-old woman with childbearing potential who underwent transsphenoidal surgery (TSS) in December 2017 to remove a non-functioning pituitary adenoma. The surgery resulted in full remission of her PMDD symptoms. The patient's hormone levels remained stable before and after the TSS procedure. During 28 months of follow-up, the woman has been asymptomatic for periods of 6 consecutive months or longer without taking antidepressants. Given the patient's current condition, a durable remission from PMDD is anticipated. CONCLUSIONS We believe that refractory PMS/PMDD associated with pituitary lesions is under-diagnosed and under reported. As demonstrated in this case, surgical intervention for a sellar mass has the potential to be effective or even curative for patients with PMS/PMDD. We recommend that physicians consider magnetic resonance imaging of the brain in patients with PMS/PMDD.
文献中鲜有报道垂体腺瘤患者出现经前期综合征（PMS）或经前期烦躁障碍（PMDD）的病例。垂体病变切除术后持续性 PMDD 症状完全缓解尚未见报道。
我们报告了一例有生育潜力的 44 岁女性，她于 2017 年 12 月接受经蝶窦手术（TSS）切除无功能垂体腺瘤。手术使她的 PMDD 症状完全缓解。患者的激素水平在 TSS 前后保持稳定。在 28 个月的随访期间，该女性在不服用抗抑郁药的情况下，连续 6 个月或更长时间无症状。鉴于患者目前的情况，预计 PMDD 可持久缓解。
我们认为与垂体病变相关的难治性 PMS/PMDD 诊断不足且报道较少。如本例所示，鞍区肿块的手术干预对 PMS/PMDD 患者可能有效甚至可治愈。我们建议医生在 PMS/PMDD 患者中考虑脑磁共振成像。
