Gonadotroph pituitary macroadenoma inducing ovarian hyperstimulation syndrome: successful response to octreotide therapy

Karapanou, Olga; Tzanela, Marinella; Tamouridis, N.; Tsagarakis, Stylianos

doi:10.14310/horm.2002.1347

Cited by 27 publications

(24 citation statements)

References 15 publications

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“…FSH secreted by the tumor cells causes the formation of the multiple ovarian cysts and may considerably increase the production of estradiol [21,22]. In some reports high estradiol levels contributed to the development of endometrial hyperplasia [17,21,23]. As a result of the negative feedback mechanism, FSH may remain within the normal range.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Recurrent and remnant tumors were common, occurring in 11 out of 29 cases; 4 patients therefore underwent reoperation. Radiotherapy and radiosurgery are used in the management of the residual or recurrent tumors [7,17,21,23,26,37,38].…”

Section: Treatmentmentioning

confidence: 99%

“…In the case of a 40-year old woman, bromocriptine administration restored regular menstrual cycles and resolved galactorrhea [39]. Somatostatin analogs might be also taken into consideration in selected cases [23].…”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Ovarian Hyperstimulation Caused by Gonadotroph Pituitary Adenoma – Review

Halupczok¹,

Kluba-Szyszka²,

Bidzińska−Speichert³

et al. 2015

Adv Clin Exp Med

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Ovarian hyperstimulation syndrome (OHSS) occurs mostly as an iatrogenic complication of assisted reproductive technology. Gonadotroph pituitary adenomas are rarely associated with OHSS. To the authors' knowledge, to date only 30 cases of spontaneous ovarian stimulation associated with gonadotroph adenomas have been reported in women and only 2 in children. The most common symptoms in such cases included menstrual disturbances, abdominal or pelvic pain, abdominal distension and increased girth. Galactorrhea, nausea and vomiting were also reported. Neurological symptoms occurred when the size of the pituitary tumor reached at least 20 mm. Transvaginal ultrasound examination usually demonstrated enlarged multicystic ovaries. MRIs of the pituitary revealed macroadenomas up to 61 mm in maximum diameter. The hormonal profiles of the reported cases showed normal or elevated FSH levels, suppressed LH levels, elevated estradiol levels and supranormal concentrations of prolactin. Transsphenoidal surgery is the therapy of choice, however other treatment modalities can be utilized in selected cases (Adv Clin Exp Med 2015, 24, 4, 695-703).

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Ovarian Hyperstimulation Caused by Gonadotroph Pituitary Adenoma – Review

Halupczok¹,

Kluba-Szyszka²,

Bidzińska−Speichert³

et al. 2015

Adv Clin Exp Med

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“…Occasional case reports have shown that dopamine agonists may reduce autonomous FSH secretion and help complete a pregnancy or improve ovarian hyperstimulation syndrome (14,15). Long-acting octreotide has achieved normalization of ovarian volumes and estradiol levels in a woman with recurrent ovarian hyperstimulation syndrome secondary to a functional gonadotroph adenoma (16). In our case, surgical removal of the tumor was incomplete.…”

mentioning

confidence: 59%

Secondary Polycythemia Attributed To An Incidentally Discovered Luteinizing Hormone–Secreting Pituitary Adenoma: A Case Report

Angelousi

Nikolopoulos

Kolomodi

et al. 2017

AACE Clinical Case Reports

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Objective: Polycythemia is a rare and often unrecognized manifestation of a functional gonadotroph adenoma. Although silent gonadotroph macroadenomas are relatively common, functional gonadotroph adenomas are rare.Methods: We report a case of a 66-year-old patient treated for chronic idiopathic polycythemia for at least 10 years, in whom a large pituitary lesion in a cerebral computed tomography (CT) scan was incidentally discovered in a cerebral computed tomography (CT) scan.Results: The patient presented with nasal erythromelalgia and facial erythrosis while being treated with hydroxyurea for primary polycythemia. CT findings and biochemical analyses revealed a large pituitary tumor and increased testosterone and luteinizing hormone (LH) levels. Following resection of the tumor, immunostaining confirmed positive staining for follicle-stimulating hormone and LH, leading to the diagnosis of a functional gonadotroph adenoma. Due to persistent radiologic and biochemical disease after surgical resection, tumoral and secretory control was achieved with combination treatment with long-acting octreotide and cabergolide. Polycythemia was resolved after the initiation of the treatment for the gonadotroph adenoma. Conclusion:This case of a rare LH-secreting pituitary adenoma illustrates that physicians should be aware of rare causes of polycythemia. Testosterone measurement should always be considered, especially in cases of polycythemia of unknown origin. In our case, the combination of treatment with somatostatin analogues and dopaminergic agonists was efficacious in reducing both the secretory and tumoral component that led to resolution of polycythemia.(AACE Clinical Case Rep. 2017;3:e54-e58) Abbreviations: FSΗ = follicle-stimulating hormone; Hb = hemoglobin; Hct = hematocrit; IHC = immunohistochemistry; LAR = long-acting release; LH = luteinizing hormone; MRI = magnetic resonance imaging

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“…Immunostaining of these tumors is variable for FSH and/or LH, often unevenly distributed [3], and with the intensity of staining not correlated with plasma levels of gonadotropins [4]. There are multiple cases reported in the literature in which a functional FSH-secreting tumor results in spontaneous ovarian hyperstimulation syndrome [5–9] and of testicular enlargement [10–12]. Functional LH secreted by the tumor is extremely unusual and to our knowledge our case is the only fifth reported case in the literature [13–16].…”

Section: Discussionmentioning

confidence: 99%

Testicular “Hyperstimulation” Syndrome: A Case of Functional Gonadotropinoma

Thakkar

Kannan

Hamrahian

et al. 2014

Case Reports in Endocrinology

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Gonadotropins secreting pituitary tumors tend to present as sellar mass with hypogonadism. Biologically active LH secretion by these tumors resulting in elevated testosterone is extremely rare. We report a case of a 48-year-old male patient who presented with giant pituitary tumor, elevated testosterone, and elevated levels of gonadotropins. Surgical resection of the tumor resulted in normalization of gonadotropins and fall in serum testosterone to subnormal levels in the postoperative period confirming that the tumor was secreting bioactive luteinizing hormone (LH).

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Gonadotroph pituitary macroadenoma inducing ovarian hyperstimulation syndrome: successful response to octreotide therapy

Cited by 27 publications

References 15 publications

Ovarian Hyperstimulation Caused by Gonadotroph Pituitary Adenoma – Review

Ovarian Hyperstimulation Caused by Gonadotroph Pituitary Adenoma – Review

Secondary Polycythemia Attributed To An Incidentally Discovered Luteinizing Hormone–Secreting Pituitary Adenoma: A Case Report

Testicular “Hyperstimulation” Syndrome: A Case of Functional Gonadotropinoma

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