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REVIEW article

Front. Endocrinol.

Sec. Pituitary Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1597813

This article is part of the Research TopicAdvances in Understanding and Managing Skull Base PathologiesView all articles

Article Title: Bilateral Atypical Ovarian Masses: Don't Overlook a Functional Gonadotropic Pituitary Adenoma

Provisionally accepted
Estelle  HagegeEstelle Hagege1*Geraldine  VitelliusGeraldine Vitellius1Anne  FevreAnne Fevre1Malorie  MostaertMalorie Mostaert1Fabien  LitreFabien Litre1Olivier  GraesslinOlivier Graesslin1Paul  PirteaPaul Pirtea2Brigitte  DelemerBrigitte Delemer1
  • 1Centre Hospitalier Universitaire de Reims, Reims, France
  • 2Hôpital Foch, Suresnes, France

The final, formatted version of the article will be published soon.

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.

Keywords: Functional gonadotroph adenoma, pituitary adenoma, ovarian mass/cyst, Ovarian Hyperstimulation Syndrome, follicle-stimulating hormone Figure 4: Diagnostic Algorithm for Ovarian Masses and Cysts: Role of Hormonal and Imaging Evaluation Estelle Hagege: conception, Data Collection, writing of the case report, corresponding author data collection. Malorie Mostaert : data collection. Fabien Litre: pituitary surgeon. Olivier Graesslin: gynecological surgeon

Received: 21 Mar 2025; Accepted: 30 May 2025.

Copyright: © 2025 Hagege, Vitellius, Fevre, Mostaert, Litre, Graesslin, Pirtea and Delemer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Estelle Hagege, Centre Hospitalier Universitaire de Reims, Reims, France

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