{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:30:05Z","timestamp":1789695005387,"version":"4.0.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Acute Sheehan\u2019s syndrome is a rare, but potentially life-threatening, obstetric event that can be complicated by diabetes insipidus. Little information on the diagnosis and treatment of Sheehan\u2019s syndrome with diabetes insipidus is available. We report on a 28-year-old patient who developed acute Sheehan\u2019s syndrome with diabetes insipidus after giving birth, and on a systematic review of similar cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review of the literature cataloged in PubMed and Google Scholar using the keywords \u201cSheehan syndrome\u201d OR \u201cSheehan's syndrome\u201d AND \u201cdiabetes insipidus\u201d to identify relevant case reports published between 1990 and 2021. Eight Reports met the inclusion criteria (English-language abstracts available, onset in the puerperium, information about the day of the onset).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the present case, postpartum curettage was necessary to remove the residual placenta. The total amount of blood loss was severe (2500\u00a0ml). On the second day postpartal, the patient developed polyuria. Laboratory analysis revealed hypernatremia with increased serum osmolality and decreased urinary osmolality. Hormone analysis showed partial hypopituitarism involving the thyroid, corticotropic, and gonadotropic axes. The prolactin level was elevated. Brain magnetic resonance imaging showed pituitary gland infarction. Desmopressin therapy was initiated and resolved the polyuria. Hormone replacement therapy was administered. Four months later, the patient was well, with partial diabetes insipidus. The literature review indicated that this case was typical in terms of symptoms and disease onset. Most reported cases involve hypotension and peripartum hemorrhage, but some patients without hemorrhage also develop Sheehan\u2019s syndrome. Elevated prolactin levels are uncommon and associated with poor prognosis in patients with Sheehan\u2019s syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acute Sheehan\u2019s syndrome with diabetes insipidus involves nearly all pituitary hormone axes, indicating severe disease. Prolactin elevation could suggest that a case of Sheehan\u2019s syndrome is severe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-021-06294-2","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T07:02:43Z","timestamp":1636959763000},"page":"699-706","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Acute Sheehan\u2019s syndrome manifesting initially with diabetes insipidus postpartum: a case report and systematic literature review"],"prefix":"10.1007","volume":"306","author":[{"given":"Gregor Leonhard","family":"Olmes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich-Franz","family":"Solomayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Caroline","family":"Radosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Sklavounos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Agne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan J.","family":"Schunk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Haj Hamoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"6294_CR1","first-page":"13","volume":"58","author":"HL Sheehan","year":"1938","unstructured":"Sheehan HL (1938) Post-partum necrosis of the anterior pituitary. Trans Edinb Obstet Soc 58:13\u201328","journal-title":"Trans Edinb Obstet Soc"},{"key":"6294_CR2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/s0002-9343(88)80346-2","volume":"85","author":"JG Gonzalez","year":"1988","unstructured":"Gonzalez JG, Elizondo G, Saldivar D et al (1988) Pituitary gland growth during normal pregnancy: an in vivo study using magnetic resonance imaging. Am J Med 85:217\u2013220. https:\/\/doi.org\/10.1016\/s0002-9343(88)80346-2","journal-title":"Am J Med"},{"key":"6294_CR3","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/s0025-6196(12)60958-6","volume":"65","author":"MO Thorner","year":"1990","unstructured":"Thorner MO (1990) Changes in the anatomy and function of the maternal anterior pituitary gland during pregnancy. Mayo Clin Proc 65:597\u2013599. https:\/\/doi.org\/10.1016\/s0025-6196(12)60958-6","journal-title":"Mayo Clin Proc"},{"key":"6294_CR4","doi-asserted-by":"publisher","first-page":"292","DOI":"10.3109\/09513590.2012.752454","volume":"29","author":"F Kilicli","year":"2013","unstructured":"Kilicli F, Dokmetas HS, Acibucu F (2013) Sheehan\u2019s syndrome. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol 29:292\u2013295. https:\/\/doi.org\/10.3109\/09513590.2012.752454","journal-title":"Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol"},{"key":"6294_CR5","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1080\/09513590600630504","volume":"22","author":"HS D\u00f6kmeta\u015f","year":"2006","unstructured":"D\u00f6kmeta\u015f HS, Kilicli F, Korkmaz S, Yonem O (2006) Characteristic features of 20 patients with Sheehan\u2019s syndrome. Gynecol Endocrinol 22:279\u2013283. https:\/\/doi.org\/10.1080\/09513590600630504","journal-title":"Gynecol Endocrinol"},{"key":"6294_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/8415860","volume":"2018","author":"JG Gonz\u00e1lez-Gonz\u00e1lez","year":"2018","unstructured":"Gonz\u00e1lez-Gonz\u00e1lez JG, Borjas-Almaguer OD, Salcido-Montenegro A et al (2018) Sheehan\u2019s syndrome revisited: underlying autoimmunity or hypoperfusion? Int J Endocrinol 2018:1\u20138. https:\/\/doi.org\/10.1155\/2018\/8415860","journal-title":"Int J Endocrinol"},{"key":"6294_CR7","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12884-017-1380-y","volume":"17","author":"S Matsuzaki","year":"2017","unstructured":"Matsuzaki S, Endo M, Ueda Y et al (2017) A case of acute Sheehan\u2019s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage. BMC Pregnancy Childbirth 17:188. https:\/\/doi.org\/10.1186\/s12884-017-1380-y","journal-title":"BMC Pregnancy Childbirth"},{"key":"6294_CR8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.4158\/EP10015.CR","volume":"17","author":"S Kumar","year":"2011","unstructured":"Kumar S, Burrows D, Dang S, Simmons D (2011) Sheehan syndrome presenting as central diabetes insipidus: a rare presentation of an uncommon disorder. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol 17:108\u2013114. https:\/\/doi.org\/10.4158\/EP10015.CR","journal-title":"Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol"},{"key":"6294_CR9","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1590\/S0004-27302011000200010","volume":"55","author":"BA Laway","year":"2011","unstructured":"Laway BA, Mir SA, Dar MI, Zargar AH (2011) Sheehan\u2019s syndrome with central diabetes insipidus. Arq Bras Endocrinol Metabol 55:171\u2013174. https:\/\/doi.org\/10.1590\/S0004-27302011000200010","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"6294_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-007022","author":"R Robalo","year":"2012","unstructured":"Robalo R, Pedroso C, Agapito A, Borges A (2012) Acute Sheehan\u2019s syndrome presenting as central diabetes insipidus. BMJ Case Rep. https:\/\/doi.org\/10.1136\/bcr-2012-007022","journal-title":"BMJ Case Rep"},{"key":"6294_CR11","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1007\/s00101-014-2291-1","volume":"63","author":"D Schlembach","year":"2014","unstructured":"Schlembach D, M\u00f6rtl MG, Girard T et al (2014) Management der postpartalen Blutung (PPH): Algorithmus der Interdisziplin\u00e4ren D-A-CH-Konsensusgruppe PPH (Deutschland\u2014\u00d6sterreich\u2014Schweiz). Anaesthesist 63:234\u2013242. https:\/\/doi.org\/10.1007\/s00101-014-2291-1","journal-title":"Anaesthesist"},{"key":"6294_CR12","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.ecl.2019.05.005","volume":"48","author":"P Chanson","year":"2019","unstructured":"Chanson P (2019) Other pituitary conditions and pregnancy. Endocrinol Metab Clin North Am 48:583\u2013603. https:\/\/doi.org\/10.1016\/j.ecl.2019.05.005","journal-title":"Endocrinol Metab Clin North Am"},{"key":"6294_CR13","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1046\/j.1365-2796.1998.00370.x","volume":"244","author":"G Dejager","year":"1998","unstructured":"Dejager G, Foubert T (1998) Sheehan\u2019s syndrome: differential diagnosis in the acute phase. J Intern Med 244:261\u2013266. https:\/\/doi.org\/10.1046\/j.1365-2796.1998.00370.x","journal-title":"J Intern Med"},{"key":"6294_CR14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1530\/EJE-10-1004","volume":"164","author":"HL Kristjansdottir","year":"2011","unstructured":"Kristjansdottir HL, Bodvarsdottir SP, Sigurjonsdottir HA (2011) Sheehan\u2019s syndrome in modern times: a nationwide retrospective study in Iceland. Eur J Endocrinol 164:349\u2013354. https:\/\/doi.org\/10.1530\/EJE-10-1004","journal-title":"Eur J Endocrinol"},{"key":"6294_CR15","first-page":"431","volume":"15","author":"P Weiner","year":"1979","unstructured":"Weiner P, Ben-Israel J, Plavnick L (1979) Sheehan\u2019s syndrome with diabetes insipidus. A case study. Isr J Med Sci 15:431\u2013433","journal-title":"Isr J Med Sci"},{"key":"6294_CR16","first-page":"16S","volume":"53","author":"ML Collins","year":"1979","unstructured":"Collins ML, O\u2019Brien P, Cline A (1979) Diabetes insipidus following obstetric shock. Obstet Gynecol 53:16S-17S","journal-title":"Obstet Gynecol"},{"key":"6294_CR17","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.1479-828X.1998.tb03009.x","volume":"38","author":"AKS Kan","year":"1998","unstructured":"Kan AKS, Calligerous D (1998) A case report of sheehan syndrome presenting with diabetes insipidus. Aust N Z J Obstet Gynaecol 38:224\u2013226. https:\/\/doi.org\/10.1111\/j.1479-828X.1998.tb03009.x","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"6294_CR18","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1081\/JDI-120015686","volume":"24","author":"H-Y Wang","year":"2002","unstructured":"Wang H-Y, Chang C-T, Wu M-S (2002) Postpartum hemorrhage complicated with irreversible renal failure and central diabetes insipidus. Ren Fail 24:849\u2013852. https:\/\/doi.org\/10.1081\/JDI-120015686","journal-title":"Ren Fail"},{"key":"6294_CR19","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1002\/path.1700850115","volume":"85","author":"HL Sheehan","year":"1963","unstructured":"Sheehan HL, Whitehead R (1963) The neurohypophysis in post-partum hypopituitaris. J Pathol Bacteriol 85:145\u2013169. https:\/\/doi.org\/10.1002\/path.1700850115","journal-title":"J Pathol Bacteriol"},{"key":"6294_CR20","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1365-2265.1987.tb00843.x","volume":"27","author":"I Jialal","year":"1987","unstructured":"Jialal I, Desai RK, Rajput MC (1987) An assessment of posterior pituitary function in patients with Sheehan\u2019s syndrome. Clin Endocrinol (Oxf) 27:91\u201395. https:\/\/doi.org\/10.1111\/j.1365-2265.1987.tb00843.x","journal-title":"Clin Endocrinol (Oxf)"},{"key":"6294_CR21","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1136\/bmj.1.5346.1679-b","volume":"1","author":"JC Sloper","year":"1963","unstructured":"Sloper JC (1963) Sheehan\u2019s syndrome and diabetes insipidus. BMJ 1:1679\u20131679. https:\/\/doi.org\/10.1136\/bmj.1.5346.1679-b","journal-title":"BMJ"},{"key":"6294_CR22","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1136\/bmj.289.6445.579","volume":"289","author":"F Bakiri","year":"1984","unstructured":"Bakiri F, Benmiloud M (1984) Antidiuretic function in Sheehan\u2019s syndrome. BMJ 289:579\u2013580. https:\/\/doi.org\/10.1136\/bmj.289.6445.579","journal-title":"BMJ"},{"key":"6294_CR23","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3109\/09513590.2010.501877","volume":"27","author":"E Adali","year":"2011","unstructured":"Adali E, Kucukaydin Z, Adali F, Yildizhan R (2011) Isolated impairment of posterior pituitary function secondary to severe postpartum haemorrhage due to uterine rupture. Gynecol Endocrinol 27:541\u2013542. https:\/\/doi.org\/10.3109\/09513590.2010.501877","journal-title":"Gynecol Endocrinol"},{"key":"6294_CR24","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ando.2016.04.005","volume":"77","author":"P Chanson","year":"2016","unstructured":"Chanson P, Salenave S (2016) Diabetes insipidus and pregnancy. Ann Endocrinol 77:135\u2013138. https:\/\/doi.org\/10.1016\/j.ando.2016.04.005","journal-title":"Ann Endocrinol"},{"key":"6294_CR25","doi-asserted-by":"publisher","DOI":"10.1530\/EDM-18-0124","author":"I Rahmani Tzvi-Ran","year":"2019","unstructured":"Rahmani Tzvi-Ran I, Olchowski J, Fraenkel M et al (2019) A rare cause of postpartum acute hyponatremia. Endocrinol Diabetes Metab Case Rep. https:\/\/doi.org\/10.1530\/EDM-18-0124","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"6294_CR26","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.annfar.2004.01.016","volume":"23","author":"M-L Catinois","year":"2004","unstructured":"Catinois M-L, Chabre O, Chirossel C et al (2004) Le syndrome de Sheehan\u202f: un diagnostic difficile en post-partum imm\u00e9diat. Ann Fr Anesth R\u00e9anim 23:508\u2013512. https:\/\/doi.org\/10.1016\/j.annfar.2004.01.016","journal-title":"Ann Fr Anesth R\u00e9anim"},{"key":"6294_CR27","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1055\/s-2007-1022724","volume":"58","author":"W Kuhn","year":"1998","unstructured":"Kuhn W, Krau\u00df T (1998) Das Sheehan-Syndrom, eine fast vergessene schwere Komplikation post partum. Geburtshilfe Frauenheilkd 58:336\u2013342. https:\/\/doi.org\/10.1055\/s-2007-1022724","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"6294_CR28","unstructured":"Schlembach D (2016) Peripartale Blutungen, Diagnostik und Therapie\u202f; AWMF-Registernummer 015\/063 Leitlinienklasse S2k. https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/015-063l_S2k_Peripartale_Blutungen_Diagnostik_Therapie_PPH_2016-04.pdf. Accessed 7 Aug 2021"},{"key":"6294_CR29","doi-asserted-by":"publisher","first-page":"759","DOI":"10.2174\/1381612053381882","volume":"11","author":"FW Bouwmeester","year":"2005","unstructured":"Bouwmeester FW, Bolte AC, van Geijn HP (2005) Pharmacological and surgical therapy for primary postpartum hemorrhage. Curr Pharm Des 11:759\u2013773. https:\/\/doi.org\/10.2174\/1381612053381882","journal-title":"Curr Pharm Des"},{"key":"6294_CR30","unstructured":"Schlembach D, M\u00f6rtl MG (2010) Postpartale H\u00e4morrhagie - Von der Definition \u00fcber die Klinik zur Diagnose. Speculum - Zeitschrift f\u00fcr Gyn\u00e4kologie und Geburtshilfe 28(1):5\u20139. https:\/\/www.kup.at\/kup\/pdf\/8662.pdf. Accessed 20 Feb 2021"},{"key":"6294_CR31","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s12020-015-0726-3","volume":"51","author":"H Diri","year":"2016","unstructured":"Diri H, Karaca Z, Tanriverdi F et al (2016) Sheehan\u2019s syndrome: new insights into an old disease. Endocrine 51:22\u201331. https:\/\/doi.org\/10.1007\/s12020-015-0726-3","journal-title":"Endocrine"},{"key":"6294_CR32","doi-asserted-by":"publisher","first-page":"338","DOI":"10.4103\/ijem.IJEM_345_20","volume":"24","author":"S Mandal","year":"2020","unstructured":"Mandal S, Mukhopadhyay P, Banerjee M, Ghosh S (2020) Clinical, endocrine, metabolic profile, and bone health in sheehan\u2019s syndrome. Indian J Endocrinol Metab 24:338. https:\/\/doi.org\/10.4103\/ijem.IJEM_345_20","journal-title":"Indian J Endocrinol Metab"},{"key":"6294_CR33","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1097\/00007611-199210000-00019","volume":"85","author":"F Kelestimur","year":"1992","unstructured":"Kelestimur F (1992) Hyperprolactinemia in a patient with Sheehan\u2019s syndrome. South Med J 85:1008\u20131010. https:\/\/doi.org\/10.1097\/00007611-199210000-00019","journal-title":"South Med J"},{"key":"6294_CR34","doi-asserted-by":"publisher","first-page":"190","DOI":"10.12998\/wjcc.v9.i1.190","volume":"9","author":"CY Liu","year":"2021","unstructured":"Liu CY, Wang YB, Zhu HQ et al (2021) Hyperprolactinemia due to pituitary metastasis: a case report. World J Clin Cases 9:190\u2013196. https:\/\/doi.org\/10.12998\/wjcc.v9.i1.190","journal-title":"World J Clin Cases"},{"key":"6294_CR35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235806","volume":"15","author":"K Uvn\u00e4s\u00adMoberg","year":"2020","unstructured":"Uvn\u00e4s\u00adMoberg K, Ekstr\u00f6m-Bergstr\u00f6m A, Buckley S et al (2020) Maternal plasma levels of oxytocin during breastfeeding\u2014a systematic review. PLoS ONE 15:e0235806. https:\/\/doi.org\/10.1371\/journal.pone.0235806","journal-title":"PLoS ONE"},{"key":"6294_CR36","doi-asserted-by":"publisher","first-page":"696","DOI":"10.4103\/2230-8210.123571","volume":"17","author":"B Laway","year":"2013","unstructured":"Laway B, Mir S, Zargar A (2013) Recovery of prolactin function following spontaneous pregnancy in a woman with Sheehan\u2032s syndrome. Indian J Endocrinol Metab 17:696. https:\/\/doi.org\/10.4103\/2230-8210.123571","journal-title":"Indian J Endocrinol Metab"},{"key":"6294_CR37","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13261","author":"M Christ-Crain","year":"2021","unstructured":"Christ-Crain M, Winzeler B, Refardt J (2021) Diagnosis and management of diabetes insipidus for the internist: an update. J Intern Med. https:\/\/doi.org\/10.1111\/joim.13261","journal-title":"J Intern Med"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06294-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-021-06294-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06294-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T08:32:11Z","timestamp":1661416331000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-021-06294-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["6294"],"URL":"https:\/\/doi.org\/10.1007\/s00404-021-06294-2","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]},"assertion":[{"value":"11 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare the following conflicts of interests. E.-F.Solomayer is receiving: grants from the University of Saarland, and Storz and Erbe; personal fees and other compensation from Roche (Basel, Switzerland), Pfizer (New York City, NY, USA), Celgene (Summit USA), Amgen (Thousand Oaks, CA, USA), and Astra Zeneca (Cambridge, UK); and other fees from Esai (Tokyo, Japan), Johnson & Johnson (New Brunswick, NJ, USA), Novartis (Basel, Switzerland), Tesaro (Waltham, MA, USA), Teva (Petach Tikwa, Israel), Medac GmbH (Wedel, Germany), MSD (Kenilworth, NJ, USA), Vifor (Sankt Gallen, Switzerland), Gedeon Richter (Budapest, Hungary), Takeda (Tokyo, Japan), and AGE (Buchholz, Germany); other potential conflicts: Clovis Oncology (Boulder, Colorado, USA), Genomic Health (Redwood City, California, USA), Jenapharm (Jena, Germany), Matramed (Bexbach, Germany), Mentor (Minneapolis, Minnesota, USA), Pharma Mar (Mardid, Spain), Samsung (Suwon, Southkorea), University of Saarland (Saarbr\u00fccken, Germany), DGGG (Berlin, Germany), AGO (Taufkirchen, Germany), AGUB (Taufkirchen, Germany), DGS (Berlin, Germany), DKG (Berlin, Germany), Saarl\u00e4ndisches Tumorzentrum am UKS e.V., University of Saarland, Homburg, Germany), Saarl\u00e4ndische Krebsgesellschaft (Saarbr\u00fccken, Germany), Stiftung Endometriose Forschung (Westerstede, Germany), ESGE (Leuven, Belgium), ETC (Saarbr\u00fccken, Germany), DEGUM (Berlin, Germany), Deutsche Kontinenzgesellschaft (Frankfurt, Germany), BLFG (Berlin, Germany), Medconcept (Neustadt an der Weinstra\u00dfe, Germany), Thieme (Stuttgart, Germany). GL Olmes, JC Radosa, P Sklavounos, P Agne, SJ Schunk, B Haj Hamoud do not have conflicts of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Waiver.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Waiver.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}