An ovarian hyperstimulation syndrome caused by gonadotropinoma in a young woman

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Abstract


From 14 to 54% of all pituitary adenomas are nonfunctioning pituitary adenomas (NPAs), their prevalence is estimated as 7.0–41.3 cases per 100 000 population. The most common type of NPAs (73% of cases) are gonadotropinomas. In most cases, gonadotropinoma is characterized by secretion of biologically inactive hormones, so the release of gonadotropins does not lead to the development of any clinical symptoms. For this reason the diagnosis of gonadotropinomas is most often performed on the basis of immunohistochemical analysis. However, in rare cases, gonadotropinomas secrete biologically active hormones, most often follicle-stimulating (FSH). Ovarian hyperstimulation syndrome due to gonadotropin-secreting pituitary tumors occurs in about 3% of women with hormonally inactive pituitary adenomas at reproductive age and in 8% of patients with verified gonadotropinomas. This clinical case describes a young patient with a rare pathology: FSH/LH-secreting macroadenoma of the pituitary, which led to the development of ovary hyperstymulation symdrome. The diagnosis of pituitary adenoma was performed due to the identified hyperprolactinemia one month before the development of visual impairment, which can be considered a late diagnosis. Surgical treatment of gonadotropinomy was carried out successfully and without complications, remission of the disease was achieved, visual function was restored, the patient successfully became pregnant.


Anna M. Gorbacheva

Endocrinology Research Centre

Author for correspondence.
Email: ann.gorbachewa@yandex.ru
ORCID iD: 0000-0003-2669-9457
SPIN-code: 9815-7509

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD

Elena G. Przhiyalkovskaya

Endocrinology Research Centre

Email: przhiyalkovskaya.elena@gmail.com
ORCID iD: 0000-0001-9119-2447
SPIN-code: 9309-3256

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

PhD

Vilen N. Azizyan

Endocrinology Research Centre

Email: medway26@gmail.com
ORCID iD: 0000-0001-9718-6099
SPIN-code: 7666-5950
Scopus Author ID: 57190410631

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD

Irina V. Stanoevich

Endocrinology Research Centre

Email: ugljesha@mail.ru
ORCID iD: 0000-0002-9681-672X
SPIN-code: 2977-8789

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

Sc.D.

Andrey Yu. Grigoriev

Endocrinology Research Centre

Email: medway26@gmail.com
ORCID iD: 0000-0002-9575-4520
SPIN-code: 8910-8130
Scopus Author ID: 57190411198

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, PhD

Anna I. Sazonova

Research Center for Obstetrics, Gynecology and Perinatology

Email: anyta_sazonova@mail.ru
ORCID iD: 0000-0002-9388-978X
SPIN-code: 4977-6460

Russian Federation, 4, akademika Oparina street, Moscow, 117997

MD, PhD, endocrinologist of the therapeutic department of Research Center for Obstetrics, Gynecology and Perinatology

Anastasiya M. Lapshina

Endocrinology Research Centre

Email: nottoforget@yandex.ru
ORCID iD: 0000-0003-4353-6705
SPIN-code: 1582-5033

Russian Federation, 11 Dm. Ulyanova street, 117036, Moscow

MD, PhD

Zhanna E. Belaya

Endocrinology Research Centre

Email: jannabelaya@gmail.com
ORCID iD: 0000-0002-6674-6441
SPIN-code: 4746-7173

Russian Federation, 11 Dm. Ulyanova street, 117036 Moscow

MD, PhD, Professor

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Supplementary files

Supplementary Files Action
1. Fig. 1. MR imaging of the patient’s brain, T1 image. View (243KB) Indexing metadata
2. Fig. 2. MR image of the pelvic organs of the patient. Polycystic enlarged ovaries are visible. View (324KB) Indexing metadata
3. Fig. 3. Histological and immunohistochemical examination of the tissue of the pituitary adenoma. View (1MB) Indexing metadata

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Copyright (c) 2019 Gorbacheva A.M., Przhiyalkovskaya E.G., Azizyan V.N., Stanoevich I.V., Grigoriev A.Y., Sazonova A.I., Lapshina A.M., Belaya Z.E.

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