Atypical onset of prolactinoma in an adolescent girl
DOI:
https://doi.org/10.6092/1828-6550/APMB.108.1.2020.CCS5Keywords:
prolactinoma, galactorrhoea, pituitary apoplexy, cabergolineAbstract
rolactin is one of the main pituitary hormones secreted from the pituitary gland and plays an important role in reproductive functions. Hyperprolactinemia (HPRL), with a prevalence of 0.4% to 5%, is considered a frequent endocrinopathy, although rare in childhood. HPRL can be related to pathological conditions, such as tumors (adenoma) or systemic diseases. With respect to prolactinomas, clinical signs manifest with mass compression of the optic chiasm and/or anterior pituitary gland and PRL hypersecretion. Here we report a case of a15-year old girl who came to our observation due to severe episodes of headache(every 3 days) during the last year, accompanied by two incidents of amaurosis (lasting 5-10 minutes, with spontaneous resolution) and also lately spontaneous galactorrhoea (for 1 month). Brain MRI identified a “pituitary microadenoma (6 mm), with minimal blood component in context and sinking the floor of the sella turcica”. The patient underwent neurosurgical evaluation, which excluded pituitary apoplexy. She started medical treatment with cabergoline (0.25 mg twice a week), with progressive resolution of symptoms and normalization of prolactin levels. Although prolactinoma is a rare condition in pediatric patients, it must be considered as a possible diagnosis in presence of galactorrhoea and headache, even without irregularities of the menstrual cycle.References
1. Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and prolactinomas. Endocrinol Metab Clin North Am 2008; 37: 67-99.
2. Catli G, Abaci A, Altincik A, Demir K, Can S, Buyukgebiz A, Bober E. Hyperprolactinemia in children: clinical features and long-term results. J Pediatr Endocrinol Metab 2012; 25: 1123-1128.
3. Catli G, Abaci A, Bober E, Buyukgebiz A Clinical and diagnostic characteristics of hyperprolactinemia in childhood and adolescence. J Pediatr Endocrinol Metab 2013; 26 (1-2): 1-11.
4. Melmed S, Casanueva FF, Ho man AR, Kleinberg DL, Montori VM, Schlechte JA,et al. Diagnosis and 5. treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 273-288.
6. Stawerska R, Smyczyńska J, Hilczer M, Lewiński A. Does elevated morning prolactin concentration in children always mean the diagnosis of hyperprolactinemia? Exp Clin Endo- crinol Diabetes 2015; 123: 405-410.
7. Michail Matalliotakis, Ioannis Koliarakis, Charoula Matalliotaki, Alexandra Trivli, Eleftheria HatzidakiClinical manifestations, evaluation and management of hyperprolactinemia in adolescent and young girls: a brief review. Acta Biomed 2019; Vol. 90, N. 1: 149-157
8. Bernard V Bouilly J Beau I Broutin I Chanson P Younga J Binart N, Germline Prolactin Receptor Mutation Is Not a Major Cause of Sporadic Prolactinoma in Humans.Neuroendocrinology 2016;103:738–745
9. Culpin E, Crank M, Igra M, Connoly D J A, Dimitri P, Mirza S, Sinha S. Pituitary tumour apoplexy within prolactinomas in children: a more aggressive condition? Pituitary 2018 21:474-479.
Hesam Ghadirian, Mohamad Shirani, Shahab Ghazi-Mirsaeed1, Saleh Mohebi, Maysam Alimohamadi. Pituitary Apoplexy during Treatment of Prolactinoma with Cabergoline. Asian Journal of Neurosurgery Volume 13, Issue, January-March 2018
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