Secondary amenorrhea and infertility caused by an inhibin-B-producing ovarian fibrothecoma.
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.
Meyer
A C
AC
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore 21201, USA.
Papadimitriou
J C
JC
Silverberg
S G
SG
Sharara
F I
FI
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
D007265:Inhibins