[Secondary amenorrhea and LH hypersecretion. An unusual report of a granulosa cell ovarian tumor].
Granulosa cell ovarian tumors are infrequent. Since they originate from the gonadal stroma, they retain a high secretory potential and some of their clinical manifestations may be secondary to the production of sexual steroids. A 36 year old woman with an ovarian tumor presenting as a secondary amenorrhea is reported. This patient had a positive progesterone test and her hormonal profile showed a maintained LH hypersecretion (> 75 mUl/ml) which, joined to the presence of a hypophyseal microadenoma lead to suspect the presence of a gonadotrophin secreting tumor. The absence of LH response to TRH and its adequate suppression using oral contraceptives discarded this diagnosis. The histopathology of the excised ovarian tumor demonstrated that it is was a granulosa cell tumor. The physiopathological explanation of the case is based on the maintained levels of estrogens produced by the tumor that, through a positive feed-back mechanism similar to that of the polycystic ovary syndrome, produced a tonic LH elevation and GnRH hyper response. After the tumor excision, ovulatory cycles resumed and the patient became pregnant, facts that confirm the postulated hypothesis.
Arteaga
E
E
Departamento de Endocrinología, Metabolismo y Nutrición, Escuela de Medicina, P Universidad Católica de Chile, Santiago de Chile.
Campusano
C
C
Fernández
C
C
D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D005260:Female; D006106:Granulosa Cell Tumor / Q000150:complications* / Q000378:metabolism; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000378:metabolism
D007986:Luteinizing Hormone
Amenorrea secundaria e hipersecreción de LH. Presentación inusual de un tumor ovárico de células de la granulosa.