Inhibin-producing ovarian granulosa cell tumor as a cause of secondary amenorrhea: case report and review of the literature

J Obstet Gynaecol Res. 2004 Dec;30(6):439-43. doi: 10.1111/j.1447-0756.2004.00231.x.

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Amenorrhea / etiology
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Granulosa Cell Tumor / blood
  • Granulosa Cell Tumor / complications
  • Granulosa Cell Tumor / diagnosis*
  • Granulosa Cell Tumor / pathology
  • Granulosa Cell Tumor / surgery
  • Humans
  • Inhibins / blood*
  • Luteinizing Hormone / blood
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery

Substances

  • inhibin B
  • Estradiol
  • Inhibins
  • Luteinizing Hormone
  • Follicle Stimulating Hormone