Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma

Functional gonadotroph adenoma (FGA) is a rare condition associated with secretion of biologically active gonadotropins which affect reproductive organs. In women of reproductive age, it has been reported as a cause of spontaneous ovarian hyperstimulation syndrome (OHSS) occurring outside the contex...

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Main Authors: Estelle Hagege, Geraldine Vitellius, Anne Fevre, Malorie Mostaert, Fabien Litre, Olivier Graesslin, Paul Pirtea, Brigitte Delemer
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1597813/full
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author Estelle Hagege
Estelle Hagege
Geraldine Vitellius
Anne Fevre
Malorie Mostaert
Fabien Litre
Olivier Graesslin
Paul Pirtea
Brigitte Delemer
author_facet Estelle Hagege
Estelle Hagege
Geraldine Vitellius
Anne Fevre
Malorie Mostaert
Fabien Litre
Olivier Graesslin
Paul Pirtea
Brigitte Delemer
author_sort Estelle Hagege
collection DOAJ
description Functional gonadotroph adenoma (FGA) is a rare condition associated with secretion of biologically active gonadotropins which affect reproductive organs. In women of reproductive age, it has been reported as a cause of spontaneous ovarian hyperstimulation syndrome (OHSS) occurring outside the context of assisted reproductive technology (ART). In rare instances, FGA may present as suspicious ovarian masses, leading to an overlooked pituitary disorder. We report the case of a 34-year-old woman initially suspected of having a bilateral ovarian tumor with a borderline component due to thick-walled cystic masses. She underwent pelvic surgery, resulting in an oophorectomy. However, a few weeks postoperatively, the sudden onset of galactorrhea prompted further investigation, revealing hyperprolactinemia, FSH hypersecretion, and low LH levels. Ultimately, the diagnosis of FGA was established. A literature review was conducted to analyze similar cases where patients underwent ovarian surgery without prior hormonal assessment or suspicion of pituitary pathology, only to be diagnosed with FGA later. Thirteen additional cases were identified, including ovarian cysts and two cases of suspicious ovarian masses, with diagnostic delays ranging from 1.5 to 10 years. This case highlights the importance of considering FGA in the differential diagnosis of bilateral ovarian masses to avoid unnecessary surgical procedures.
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spelling doaj-art-77a6997bc2ec4015839a4cdae03ad5f92025-08-20T02:10:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15978131597813Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenomaEstelle Hagege0Estelle Hagege1Geraldine Vitellius2Anne Fevre3Malorie Mostaert4Fabien Litre5Olivier Graesslin6Paul Pirtea7Brigitte Delemer8Department of Endocrinology, Endocrinology and Gynecology, Reims University Hospital Center, Reims, FranceDepartment of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, FranceDepartment of Endocrinology, Endocrinology and Gynecology, Reims University Hospital Center, Reims, FranceDepartment of Endocrinology, Endocrinology and Gynecology, Reims University Hospital Center, Reims, FranceDepartment of Endocrinology, Endocrinology and Gynecology, Reims University Hospital Center, Reims, FranceDepartment of Neurosurgery, Reims University Hospital Center, Reims, FranceDepartment of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, FranceDepartment of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, Suresnes, FranceDepartment of Endocrinology, Endocrinology and Gynecology, Reims University Hospital Center, Reims, FranceFunctional gonadotroph adenoma (FGA) is a rare condition associated with secretion of biologically active gonadotropins which affect reproductive organs. In women of reproductive age, it has been reported as a cause of spontaneous ovarian hyperstimulation syndrome (OHSS) occurring outside the context of assisted reproductive technology (ART). In rare instances, FGA may present as suspicious ovarian masses, leading to an overlooked pituitary disorder. We report the case of a 34-year-old woman initially suspected of having a bilateral ovarian tumor with a borderline component due to thick-walled cystic masses. She underwent pelvic surgery, resulting in an oophorectomy. However, a few weeks postoperatively, the sudden onset of galactorrhea prompted further investigation, revealing hyperprolactinemia, FSH hypersecretion, and low LH levels. Ultimately, the diagnosis of FGA was established. A literature review was conducted to analyze similar cases where patients underwent ovarian surgery without prior hormonal assessment or suspicion of pituitary pathology, only to be diagnosed with FGA later. Thirteen additional cases were identified, including ovarian cysts and two cases of suspicious ovarian masses, with diagnostic delays ranging from 1.5 to 10 years. This case highlights the importance of considering FGA in the differential diagnosis of bilateral ovarian masses to avoid unnecessary surgical procedures.https://www.frontiersin.org/articles/10.3389/fendo.2025.1597813/fullfunctional gonadotroph adenomapituitary adenomaovarian mass/cystovarian hyperstimulation syndromefollicle-stimulating hormone
spellingShingle Estelle Hagege
Estelle Hagege
Geraldine Vitellius
Anne Fevre
Malorie Mostaert
Fabien Litre
Olivier Graesslin
Paul Pirtea
Brigitte Delemer
Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
Frontiers in Endocrinology
functional gonadotroph adenoma
pituitary adenoma
ovarian mass/cyst
ovarian hyperstimulation syndrome
follicle-stimulating hormone
title Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
title_full Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
title_fullStr Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
title_full_unstemmed Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
title_short Bilateral atypical ovarian masses: don’t overlook a functional gonadotropic pituitary adenoma
title_sort bilateral atypical ovarian masses don t overlook a functional gonadotropic pituitary adenoma
topic functional gonadotroph adenoma
pituitary adenoma
ovarian mass/cyst
ovarian hyperstimulation syndrome
follicle-stimulating hormone
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1597813/full
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