垂体促性腺激素腺瘤继发卵巢过度刺激综合征

Spontaneous ovary hyperstimulation caused by gonadotroph adenomas

目的垂体促性腺激素腺瘤多缺乏典型内分泌症状,讨论导致卵巢过度刺激综合征(OHSS)的垂体促性腺激素腺瘤的临床表现、治疗以及预后。方法报道一例垂体大腺瘤伴OHSS病例,并回顾总结截止2016年4月Pubmed、万方数据库中34例绝经前女性患有功能性垂体促性腺激素腺瘤继发OHSS的病例共35例。结果 35例患者中,33例为成年女性,2例为儿童。多数患者主因月经问题前来就诊。垂体腺瘤多为大腺瘤,直径7~61 mm不等,平均20.2 mm。31例行垂体腺瘤切除手术,复发率为35%。有22例患者在病程中曾行药物治疗,疗效不佳。结论绝经前妇女出现OHSS时需考虑功能性垂体促性腺激素腺瘤的诊断。

AbstractObjectiveThe majority of gonadotroph adenomas lack specific endocrinology symtoms. This paper discusses the clinical manifestations, treatments and prognosis of Spontaneous OHSS （ovary hyperstimulation syndrome） caused by functioning gonadotroph adenomas.MethodsThe paper reported a case of functioning gonadotroph adenomas with OHSS and summarizes 34 reported cases in Pubmed and WanFang Database before April 2016. The total number of the cases reported in this paper was 35. ResultsAmong 35 cases, 33 cases were adult women and 2 cases were children. Most of the patients came for treatment due to menstrual problems. The adenomas were mostly macroadenoma, while the diameter of the tumor ranged from 7 mm to 61 mm and its average diameter was 20.2 mm. A total of 31 cases were performed the resection of pituitary adenoma and the recurrence rate was 35%; while 22 cases took the medication during their disease duration without remarkable effect. ConclusionPremenopausal women with spontaneous OHSS should consider the diagnosis of functioning gonadotroph adenoma.