Objective: To describe the clinical symptoms associated with the diagnosis of pituitary gonadotroph adenoma in premenopausal women. Design: Report of three separate cases. Setting: University medical center. Patient(s...Objective: To describe the clinical symptoms associated with the diagnosis of pituitary gonadotroph adenoma in premenopausal women. Design: Report of three separate cases. Setting: University medical center. Patient(s): Three patients: a 31-year-old woman with primary infertility, recurrent adnexal masses, and highly elevated estradiol level; a 30-year-old woman with recurrent multicystic ovaries following multiple cystectomies and transvaginal cyst aspirations, and elevated estradiol level; a 43-year-old woman with bilateral complex cystic adnexal masses and an elevated estradiol level, who under-went a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a suspected granulosa cell tumor. Intervention(s): Transsphenoidal resection of a pituitary mass. Main Outcome Measure(s): Serum estradiol, FSH, and LH levels; transvaginal ultrasonography of the ovaries; histologic examination of pituitary tumors. Result(s): Transsphenoidal resection of pituitary adenomas resulted in normalization of serum estradiol and FSH levels and resolution of adnexal masses in two of the women. Conclusion(s): Pituitary gonadotroph adenoma must be considered in the differential diagnosis in reproductive-aged women presenting with the clinical symptom triad of new onset oligomenorrhea, bilateral cystic adnexal masses, and elevated estradiol and FSH levels with suppressed levels of LH; timely diagnosis may prevent unnecessary and potentially damaging surgical procedures.展开更多
文摘Objective: To describe the clinical symptoms associated with the diagnosis of pituitary gonadotroph adenoma in premenopausal women. Design: Report of three separate cases. Setting: University medical center. Patient(s): Three patients: a 31-year-old woman with primary infertility, recurrent adnexal masses, and highly elevated estradiol level; a 30-year-old woman with recurrent multicystic ovaries following multiple cystectomies and transvaginal cyst aspirations, and elevated estradiol level; a 43-year-old woman with bilateral complex cystic adnexal masses and an elevated estradiol level, who under-went a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a suspected granulosa cell tumor. Intervention(s): Transsphenoidal resection of a pituitary mass. Main Outcome Measure(s): Serum estradiol, FSH, and LH levels; transvaginal ultrasonography of the ovaries; histologic examination of pituitary tumors. Result(s): Transsphenoidal resection of pituitary adenomas resulted in normalization of serum estradiol and FSH levels and resolution of adnexal masses in two of the women. Conclusion(s): Pituitary gonadotroph adenoma must be considered in the differential diagnosis in reproductive-aged women presenting with the clinical symptom triad of new onset oligomenorrhea, bilateral cystic adnexal masses, and elevated estradiol and FSH levels with suppressed levels of LH; timely diagnosis may prevent unnecessary and potentially damaging surgical procedures.
