problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl10178problendo-10178Research ArticleКлинические случаиCase ReportsКлинически активная гонадотропинома c развитием синдрома гиперстимуляции яичников у молодой женщиныAn ovarian hyperstimulation syndrome caused by gonadotropinoma in a young womanhttps://orcid.org/0000-0003-2669-9457ГорбачеваАнна МаксимовнаGorbachevaAnna M.

MD

ann.gorbachewa@yandex.ruhttps://orcid.org/0000-0001-9119-2447ПржиялковскаяЕлена ГеоргиевнаPrzhiyalkovskayaElena G.

к.м.н.

PhD

przhiyalkovskaya.elena@gmail.comhttps://orcid.org/0000-0001-9718-6099АзизянВилен НероновичAzizyanVilen N.

отделение нейрохирургии

MD

medway26@gmail.comhttps://orcid.org/0000-0002-9681-672XСтаноевичИрина ВасильевнаStanoevichIrina V.

доктор медицинских наук

Sc.D.

ugljesha@mail.ruhttps://orcid.org/0000-0002-9575-4520ГригорьевАндрей ЮрьевичGrigorievAndrey Yu.

д.м.н.

MD, PhD

medway26@gmail.comhttps://orcid.org/0000-0002-9388-978XСазоноваАнна ИгоревнаSazonovaAnna I.

кандидат медицинских наук, врач-эндокринолог терапевтического отделения

MD, PhD, endocrinologist of the therapeutic department of Research Center for Obstetrics, Gynecology and Perinatology

anyta_sazonova@mail.ruhttps://orcid.org/0000-0003-4353-6705ЛапшинаАнастасия МихайловнаLapshinaAnastasiya M.

Кандидат медицинских наук, врач-патологоанатом отдела фундаментальной патоморфологии

MD, PhD

nottoforget@yandex.ruhttps://orcid.org/0000-0002-6674-6441БелаяЖанна ЕвгеньевнаBelayaZhanna E.

д.м.н., зав. отделения нейроэндокринологии и остеопатий,

профессор кафедры эндокринология, института высшего и дополнительного образования 

MD, PhD, Professor

jannabelaya@gmail.comФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияEndocrinology Research CentreRussian FederationФГБУ Научный центр акушерства, гинекологии и перинатологии им. В.И. КулаковаРоссияResearch Center for Obstetrics, Gynecology and PerinatologyRussian Federation201925102019654278288Copyright © Горбачева А.М., Пржиялковская Е.Г., Азизян В.Н., Станоевич И.В., Григорьев А.Ю., Сазонова А.И., Лапшина А.М., Белая Ж.Е., 20192019Горбачева А.М., Пржиялковская Е.Г., Азизян В.Н., Станоевич И.В., Григорьев А.Ю., Сазонова А.И., Лапшина А.М., Белая Ж.Е.Gorbacheva A.M., Przhiyalkovskaya E.G., Azizyan V.N., Stanoevich I.V., Grigoriev A.Y., Sazonova A.I., Lapshina A.M., Belaya Z.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/10178

Гормонально-неактивные аденомы гипофиза (ГНАГ) составляют от 14 до 54% всех аденом гипофиза, их распространенность оценивается в 7,0–41,3 случая на 100 000 населения. Наиболее часто встречающимся видом ГНАГ (73%) являются гонадотропиномы. В большинстве случаев для гонадотропином характерна секреция биологически неактивных гормонов, поэтому выделение гонадотропинов не приводит к развитию каких-либо клинических симптомов. По этой причине диагноз гонадотропиномы чаще всего устанавливают на основании результатов иммуногистохимического исследования. Однако в редких случаях гонадотропиномы секретируют биологически активные гормоны, чаще всего фолликулостимулирующий (ФСГ), реже лютеинизирующий (ЛГ). Синдром гиперстимуляции яичников (СГЯ) вследствие гонадотропинсекретирующей опухоли гипофиза встречается примерно у 3% женщин с гормонально-неактивными аденомами гипофиза в репродуктивном возрасте и 8% пациенток с верифицированной гонадотропиномой. В представленном клиническом наблюдении мы описываем молодую пациентку с ФСГ/ЛГ-секретирующей макроаденомой гипофиза, которая привела к развитию синдрома СГЯ. Диагноз аденомы гипофиза был установлен благодаря выявленной гиперпролактинемии за 1 мес до развития зрительных нарушений, что можно считать несвоевременной диагностикой. Хирургическое лечение гонадотропиномы было проведено успешно и без осложнений: достигнута ремиссия заболевания, восстановлена зрительная функция, наступила беременность.

From 14 to 54% of all pituitary adenomas are nonfunctioning pituitary adenomas (NPAs), their prevalence is estimated as 7.0–41.3 cases per 100 000 population. The most common type of NPAs (73% of cases) are gonadotropinomas. In most cases, gonadotropinoma is characterized by secretion of biologically inactive hormones, so the release of gonadotropins does not lead to the development of any clinical symptoms. For this reason the diagnosis of gonadotropinomas is most often performed on the basis of immunohistochemical analysis. However, in rare cases, gonadotropinomas secrete biologically active hormones, most often follicle-stimulating (FSH). Ovarian hyperstimulation syndrome due to gonadotropin-secreting pituitary tumors occurs in about 3% of women with hormonally inactive pituitary adenomas at reproductive age and in 8% of patients with verified gonadotropinomas. This clinical case describes a young patient with a rare pathology: FSH/LH-secreting macroadenoma of the pituitary, which led to the development of ovary hyperstymulation symdrome. The diagnosis of pituitary adenoma was performed due to the identified hyperprolactinemia one month before the development of visual impairment, which can be considered a late diagnosis. Surgical treatment of gonadotropinomy was carried out successfully and without complications, remission of the disease was achieved, visual function was restored, the patient successfully became pregnant.

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The authors declare that there are no conflicts of interest present.