title: Secondary amenorrhea and infertility caused by an inhibin-B-producing ovarian fibrothecoma.
abstract: OBJECTIVE
  To report a case of secondary amenorrhea and infertility caused by an inhibin-B-producing ovarian fibrothecoma.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A 37-year-old woman with a 2-year history of secondary amenorrhea and infertility.
  
  
  METHODS
  Operative removal of a 5-cm ovarian fibrothecoma.
  
  
  METHODS
  Luteinizing hormone, FSH, E2, inhibin-B, TSH, and prolactin measured preoperatively and postoperatively. Immunostaining of tumor cells for inhibin and LH.
  
  
  RESULTS
  Preoperative hormone levels were as follows: FSH, 1.7 mIU/mL; LH, 23.4 mIU/mL; E2, 31 pg/mL; and inhibin B, 1,154 pg/mL. Three weeks postoperatively, the FSH was 1.5 mIU/mL, LH decreased to 7.1 mIU/mL, E2 increased to 276 pg/mL, and inhibin-B decreased to 17 pg/mL. The fibrothecoma did not stain for LH but was strongly positive for inhibin. Regular menstrual cycles resumed 28 days postoperatively.
  
  
  CONCLUSIONS
  Inhibin-B produced by an ovarian tumor profoundly suppressed FSH levels and resulted in secondary amenorrhea and infertility. Use of sensitive and specific immunoassays for inhibin-A and -B may aid in the differential diagnosis of hormonally active ovarian tumors.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore 21201, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Meyer
authors.forename: J C
authors.initials: JC
authors.lastname: Papadimitriou
authors.forename: S G
authors.initials: SG
authors.lastname: Silverberg
authors.forename: F I
authors.initials: FI
authors.lastname: Sharara
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007247:Infertility, Female / Q000209:etiology*; D007265:Inhibins / Q000378:metabolism*; D008854:Microscopy, Electron; D010051:Ovarian Neoplasms / Q000150:complications* / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D013798:Thecoma / Q000150:complications* / Q000378:metabolism* / Q000473:pathology / Q000628:therapy
chemical_list: D007265:Inhibins