UNANTICIPATED PREGNANCY WITH INTRAUTERINE GROWTH-RETARDATION AFTER RADIATION-INDUCED OVARIAN FAILURE - A CASE-REPORT

BACKGROUND: Ovarian failure is common after pelvic irradiation and is dependent upon radiation dose and patient age. This case report demons trates the resumption of ovulation and pregnancy subsequent to this di agnosis. CASE: An enlarging abdominal mass was noted in a 28-year-old female 20 months after resection of a pelvic hemangiopericytoma. She h ad received postoperative adjuvant hemipelvic radiotherapy and subsequ ently developed amenorrhea and symptoms of hypoestrogenism. Serum foll icle-stimulating hormone (FSH) was elevated. In light of the diagnosis of ovarian failure, the finding of an intrauterine pregnancy on an ab dominal computed tomography scout film, performed to rule out a recurr ence of the primary tumor, was unexpected. CONCLUSION: While amenorrhe a and elevation in serum gonadotropin levels are common after pelvic i rradiation, the clinician must be cognizant of the potential for resum ption of ovulation after radiotherapy. The diagnosis of ovarian failur e should be based on more than a single serum FSH level. Further, radi ation changes in the endometrium and myometrium as well as in uterine blood flow may have an adverse effect on pregnancy outcome. We suspect these effects had an etiologic influence on the fetal growth retardat ion in this pregnancy.