背景:功能性促性腺激素腺瘤是非常罕见的垂体肿瘤,分泌促性腺激素并表现出独特的临床表现。这里,我们报告一例育龄女性的功能性促性腺激腺瘤,并讨论其诊断和治疗。
方法:一名21岁女性腹痛患者,月经不调,高雌激素血症,并包括卵巢肿块。脑磁共振成像(MRI)显示垂体大腺瘤,经蝶窦手术缓解了她的临床症状.在经蝶窦手术前,血浆CA125,雌二醇水平升高,而催乳素,黄体生成素,促卵泡激素,PROG,皮质醇,FT4,促甲状腺激素,甲状旁腺激素,GH水平维持在正常水平。经蝶窦手术后,患者被诊断为功能性促性腺激性腺瘤。随访期间,盆腔超声证实患者卵巢大小正常,月经周期恢复正常,荷尔蒙维持在正常范围内.随访两年后没有肿瘤复发的证据。
结论:高雌激素血症患者应考虑早期诊断为功能性促性腺激素腺瘤,月经不调,大的或复发性卵巢囊肿,和视野缺陷。应该进行垂体MRI检查,建议经蝶窦手术治疗这种疾病。
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.
METHODS: 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.
CONCLUSIONS: 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.