title: Inhibin-producing ovarian granulosa cell tumor as a cause of secondary amenorrhea: case report and review of the literature.
abstract: We report the case of 31-year-old patient with an inhibin B-secreting granulosa cell tumor of the left ovary who presented with secondary amenorrhea. Preoperative serum hormonal levels were as follows: follicle-stimulating hormone (FSH) 0.3 mIU/mL, luteinizing hormone (LH) 9.81 mIU/mL, estradiol 142.0 pg/mL and inhibin B 2429 pg/mL. Gonadotropin-releasing hormone (GnRH) test revealed no FSH response and a normal LH response. After removal of the tumor, the levels of FSH and inhibin B returned to within the normal range, and regular menses resumed 27 days postoperatively. In premenopausal women, secondary amenorrhea may be the initial manifestation of granulosa cell tumor. A low FSH level coupled with normal levels of E2 and LH, the inhibition of the FSH response to GnRH and an elevated inhibin level suggest the presence of an inhibin-secreting ovarian tumor and also rule out the possibility of isolated FSH deficiency.
authors.affiliation: Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kurihara
authors.forename: Toshio
authors.initials: T
authors.lastname: Hirakawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Amada
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Hitoo
authors.initials: H
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006106:Granulosa Cell Tumor / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007986:Luteinizing Hormone / Q000097:blood; D010051:Ovarian Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
chemical_list: C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone