Follicle stimulating hormone-secreting pituitary microadenoma with fluctuating levels of ovarian hyperstimulation.

BACKGROUND

Enlarged multicystic ovaries and an elevated estradiol (E2) concentration have been reported as characteristics of follicle stimulating hormone (FSH)-secreting adenomas in reproductive-aged women. The natural course of the hormone in relationship to the microadenoma and ovarian findings, however, remains largely unknown.

CASE: A 40-year-old woman with enlarged multicystic ovaries was nonsurgically diagnosed with an FSH-producing pituitary microadenoma. During her subsequent 12-month follow-up, the serum concentration of E2, but not FSH, and the size of the multicystic ovaries fluctuated dramatically. Both the E2 level and ovarian size were transiently normalized.

CONCLUSION

Because of disease-related fluctuations, a reproductive-aged woman with an FSH-producing adenoma did not always present with laboratory values characteristic of ovarian hyperstimulation. This finding points out a possible pitfall in diagnosis and clinical management.