He Y, Gao YT, Sun L. Functioning gonadotroph adenoma with hyperestrogenemia and ovarian hyperstimulation in a reproductive-aged woman: A case report and review of literature. World J Clin Cases 2023; 11(6): 1341-1348 [PMID: 36926127 DOI: 10.12998/wjcc.v11.i6.1341]
Corresponding Author of This Article
Li Sun, MD, Chief Doctor, Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. xjsunli@sina.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2023; 11(6): 1341-1348 Published online Feb 26, 2023. doi: 10.12998/wjcc.v11.i6.1341
Functioning gonadotroph adenoma with hyperestrogenemia and ovarian hyperstimulation in a reproductive-aged woman: A case report and review of literature
Ying He, Yu-Tao Gao, Li Sun
Ying He, Yu-Tao Gao, Li Sun, Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong Province, China
Li Sun, Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: He Y contributed to manuscript writing, editing, and data collection; Gao YT contributed to manuscript editing; Sun L contributed to supervision; all authors have read and approved the final manuscript.
Supported byShenzhen High-level Hospital Construction Fund and Sanming Project of Medicine in Shenzhen, No. SZSM201812075.
Informed consent statement: Written informed consent was obtained from the patient for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Sun, MD, Chief Doctor, Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. xjsunli@sina.com
Received: November 26, 2022 Peer-review started: November 26, 2022 First decision: December 19, 2022 Revised: December 28, 2022 Accepted: February 2, 2023 Article in press: February 2, 2023 Published online: February 26, 2023
Abstract
BACKGROUND
Functioning gonadotroph adenomas are extremely rare pituitary tumors that secrete gonadotropins and exhibit distinct clinical manifestations. Here, we report a case of functioning gonadotroph adenoma in a reproductive-aged woman and discuss its diagnosis and management.
CASE SUMMARY
A 21-year-old female patient with abdominal pain, irregular menstruation, hyperestrogenemia, and an ovarian mass was included. Brain magnetic resonance imaging (MRI) revealed a pituitary macroadenoma, and transsphenoidal surgery relieved her clinical symptoms. Before transsphenoidal surgery, plasma CA125, estradiol levels were elevated, while prolactin, luteinizing hormone, follicle-stimulating hormone, PROG, cortisol, FT4, thyroid-stimulating hormone, parathyroid hormone, and GH levels were maintained at normal levels. After transsphenoidal surgery, the patient was diagnosed with a functioning gonadotroph adenoma. During follow-up, pelvic ultrasound confirmed normal-sized ovaries in the patient, the menstrual cycle returned to regular, and her hormones were maintained within a normal range. There was no evidence of tumor recurrence after two years of follow-up.
CONCLUSION
Early diagnosis of functioning gonadotroph adenomas should be considered in patients with hyperestrogenism, irregular menstruation, large or recurrent ovarian cysts, and visual field defects. Pituitary MRI should be performed, and transsphenoidal surgery is recommended for the management of this disease.
Core Tip: Functional gonadotroph adenomas (FGAs) are rare pituitary gland tumors. Here, we describe a case of FGAs in a woman of reproductive age with abdominal pain, irregular menstruation, hyperestrogenemia, and ovarian mass. We would like to share our experience of diagnosis and treatment, which will help clinicians make appropriate decisions in the future.
