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영문초록
Gonadotroph pituitary adenomas have been classified as non-functioning tumor, since most of them are non-secreting tumor or biologically inactive hormones are produced from the tumors. Clinical symptoms and signs are delayed until the tumor grows enough to reveal neurological symptoms.Gonadotrophin secreting pituitary adenoma causing an ovarian hyperstimulation syndrome(OHSS) has been very rare in fertile years. We experienced two cases of FSH-secreting pituitary macroadenoma (FSHoma) with OHSS in reproductive-aged women. A 33-year-old woman having a history of ovarian cystectomy due to bilateral ovarian tumors complained visual disturbance. In the other case, a 31-year-old woman referred to our hospital due to multiple problems including infertility, both ovarian masses and decreased visual acuity. In both cases, the pituitary macroadenomas compressing optic chiasm were detected by asellar MRI.Pelvic MRI showed multiple septated ovarian cystic masses and laboratory findings revealed high FSH and estradiol with decreased LH levels in both two cases. Tumor removal through trans-sphenoidal approach was performed and immunohistochemical staining of resected pituitary tumors was positive for FSH. After the surgery, both women`s visual symptom improved and hormonal levels normalized. A woman presented with infertility regained fertility after the surgery and she delivered a healthy son. In infertile women presenting with symptoms of ovarian hyperstimulation and imaging features of bilateral large cystic ovarian masses, the possibility of FSHoma should be considered to avoid unnecessary gynecologic intervention and to prompt early diagnosis of pituitary tumor.
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