Full Remission of Long-Term Premenstrual Dysphoric Disorder-Like Symptoms Following Resection of a Pituitary Adenoma: Case Report
Unusual clinical course, Unusual or unexpected effect of treatment
Guangrong Lu, Tiana M. Shiver, Spiros L. Blackburn, William C. Yao, Meenakshi B. Bhattacharjee, Jay-Jiguang Zhu
The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston (UTHealth®), McGovern Medical School, Houston, TX, USA
Am J Case Rep 2020; 21:e922797
Available online: 2020-06-22
Few case reports exist in the literature of patients with pituitary adenoma presenting with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Complete remission of persistent PMDD symptoms after surgical removal of a pituitary lesion has not been reported.
CASE REPORT: We report a case of a 44-year-old woman with childbearing potential who underwent transsphenoidal surgery (TSS) in December 2017 to remove a non-functioning pituitary adenoma. The surgery resulted in full remission of her PMDD symptoms. The patient’s hormone levels remained stable before and after the TSS procedure. During 28 months of follow-up, the woman has been asymptomatic for periods of 6 consecutive months or longer without taking antidepressants. Given the patient’s current condition, a durable remission from PMDD is anticipated.
CONCLUSIONS: We believe that refractory PMS/PMDD associated with pituitary lesions is under-diagnosed and under reported. As demonstrated in this case, surgical intervention for a sellar mass has the potential to be effective or even curative for patients with PMS/PMDD. We recommend that physicians consider magnetic resonance imaging of the brain in patients with PMS/PMDD.
Keywords: Magnetic Resonance Imaging, Neurosurgical Procedures, Pituitary Neoplasms, Premenstrual Syndrome