11/39. Convexity meningioma with galactorrhea and hyperprolactinemia. A case report.A case is reported of a huge convexity meningioma associated with galactorrhea and an elevated serum prolactin level of 41 ng/mL. Total removal of the tumor resulted in a return of the prolactin level to normal (9.7 ng/mL). Because of a severe mass effect, the distant tumor might have encroached upon the hypothalamic-pituitary axis and interrupted PRL inhibitory factor regulation.- - - - - - - - - - ranking = 1keywords = pituitary (Clic here for more details about this article) |
12/39. Effects of cyproterone acetate, LHRH agonist and ovarian surgery in McCune-Albright syndrome with precocious puberty and galactorrhea.We have studied the endocrinological pattern in a girl with McCune-Albright syndrome. The young patient showed: normal prepubertal serum levels of gonadotropins, fluctuating estrogen concentrations, which sometimes were similar to the levels in adult women of fertile age, hyperprolactinemia with galactorrhea, ovarian cysts. The effects of treatment with antiandrogen drug, cyproterone acetate, and of a LHRH agonist, buserelin (less than D-Ser[TBU(8)6-des-gly NH2.10 greater than LHRH ethylamide), were studied. cyproterone acetate with or without buserelin did not fully suppress estradiol concentrations. On the other hand, surgical resection of these cysts resulted in both clinical and endocrinological remission. It is likely that in this case of McCune-Albright syndrome precocious puberty was a result of ovarian estrogen secretion, while pubertal activation of the hypothalamus-pituitary axis was absent. hyperprolactinemia, which appeared after the beginning of the combined therapy with buserelin and cyproterone acetate, was probably due to the elevated estrogen levels.- - - - - - - - - - ranking = 1keywords = pituitary (Clic here for more details about this article) |
13/39. Isolated prolactin deficiency in a woman with puerperal alactogenesis.Idiopathic PRL deficiency was detected in a parturient woman with otherwise normal pituitary function. This PRL disorder first became manifest postpartum when she had no milk production, and oral metoclopramide failed to raise her serum PRL levels. Her second pregnancy occurred spontaneously after 3 yr of attempts to conceive. During the pregnancy, her serum PRL concentration was very low, varying from 4.5-7.8 ng/ml, and the puerperium was again characterized by alactogenesis. During normal menstrual cycles and after iv GnRH, TRH, metoclopramide, and insulin tolerance tests, serum PRL was only rarely detectable by RIA, at very low concentrations. Bioassay results confirmed the PRL deficiency. The results confirm that PRL is necessary for puerperal lactation and suggest that it is needed for normal ovarian function. The present data also suggest that the maternal pituitary is the main source of serum PRL during pregnancy, and the decidua has only a minor contribution in this respect.- - - - - - - - - - ranking = 2keywords = pituitary (Clic here for more details about this article) |
14/39. amenorrhea-galactorrhea due to occult hypothyroidism.A 25-year-old woman with galactorrhea, oligomenorrhea, hyperprolactinemia, and CT evidence of pituitary enlargement had transsphenoidal microsurgery with initial resolution of hyperprolactinemia, but persistent oligomenorrhea and galactorrhea. In retrospect, she had biochemical evidence of primary hypothyroidism before operation, despite being clinically euthyroid. Administration of thyroid hormone resulted in resolution of the pituitary enlargement and the symptoms.- - - - - - - - - - ranking = 2keywords = pituitary (Clic here for more details about this article) |
15/39. Resolution of acromegaly, amenorrhea-galactorrhea syndrome, and hypergastrinemia after resection of jejunal carcinoid.A young woman presented with acromegaly and amenorrhea-galactorrhea with hypersomatotropinemia and hyperprolactinemia. In addition, she had hypergastrinemia with abnormal secretory dynamics and evidence of a large pituitary tumor with suprasellar extension and erosion of the floor of the sella turcica. Evaluation of secretory diarrhea revealed a large abdominal tumor, which on removal was found to be a carcinoid of the jejunum. Postoperatively, the acromegaly, amenorrhea-galactorrhea, and hypergastrinemia resolved, and the pituitary returned to normal size, with regrowth of the sella floor. The carcinoid tumor was shown by immunoperoxidase staining to contain GH-releasing hormone.- - - - - - - - - - ranking = 2keywords = pituitary (Clic here for more details about this article) |
16/39. Galactorrhoea and hypogonadism associated with a radiologically-inapparent prolactin-secreting pituitary tumour.A 38 year old man was investigated because of impotence, gynaecomastia and galactorrhoea. Hyperprolactinaemia and hypogonadism were documented. Pituitary function was otherwise normal as was tomographic examination of the sella turcica. In the absence of direct evidence of pituitary involvement (hyperprolactinaemia can suppress gonadal function) and to exclude ectopic prolactin production, venous blood was drawn at multiple sites. The highest prolactin levels were found in the superior vena cava and above, indicating an intracranial source. At transsphenoidal hypophysectomy a microadenoma was removed; tumour cells contained typical prolactin secretory granules on electron microscopy. In the light of this report the appropriateness of dividing hyperprolactinaemia into "tumourous" and "idiopathic" subgroups on the basis of sella size must be reconsidered. Functional tests do not distinguish between the subgroups although prolactin levels tend to be higher when the sella is enlarged. Only a quantitative rather than a qualitative difference may exist between the subgroups.- - - - - - - - - - ranking = 5keywords = pituitary (Clic here for more details about this article) |
17/39. galactorrhea in a 12-year-old boy with a chromophobe adenoma.A 12-year-old with galactorrhea is presented. He was in early puberty, had gynecomastia, and was markedly obese. Roentgenograms of the skull showed an asymmetrically enlarged sella trucica, but pneumoencephalography did not indicate suprasellar extension of the pituitary tumor. Preoperative studies of anterior pituitary function were normal except for persistent hyperprolactinemia. By transsphenoidal approach, a microadenoma of the pituitary was removed. lactation ceased within a week, and four months postoperatively the patient had normal anterior pituitary function studies. A review of the literature indicates that galactorrhea in males is very rare. The most frequently documented cause, excluding drug ingestion, is a pituitary tumor.- - - - - - - - - - ranking = 5keywords = pituitary (Clic here for more details about this article) |
18/39. Hypothalamic hypopituitarism presenting as galactorrhea-amenorrhea.A young woman with secondary amenorrhea was also found to have a deficiency of growth hormone. Functional deficiency of adrenocorticotropic and thyroid stimulating hormones, and probably prolactin-inhibiting hormone, developed subsequently. No evidence of a mass lesion in the hypothalamic pituitary axis was found. She failed to respond to any pharmacologic agent believed to act functionally at a suprapituitary level, but responded to all stimuli believed to act directly on the pituitary. This progressive failure of the endocrine hypothalamus may be an extension of the idiopathic hypopituitarism syndrome found in children.- - - - - - - - - - ranking = 3keywords = pituitary (Clic here for more details about this article) |
19/39. galactorrhea, amenorrhea, hyperprolactinemia, and an empty sella.Increased serum prolactin (hPRL) and increased volume of the sella turcica as detected by roentgenography are compatible with a pituitary adenoma. The empty sella syndrome can increase sella volume, but is usually associated with minimal, if any, endocrine dysfunction. The present case details a young woman with amenorrhea, galactorrhea, elevated serum hPRL, and roentgenographic evidence of an enlarged sella turcica. pneumoencephalography with hypocycloidal polytomography is interpreted as both an empty sella, and evidence of a pituitary adenoma. The etiology and endocrine findings in the empty sella syndrome are discussed.- - - - - - - - - - ranking = 2keywords = pituitary (Clic here for more details about this article) |
20/39. Clinical, biochemical, and radiologic reversibility of hyperprolactinemic galactorrhea-amenorrhea and abnormal sella by thyroxine in a patient with primary hypothyroidism.A case of primary hypothyroidism associated with postpartum galactorrhea-amenorrhea is reported. The configuration of the sella was compatible with pituitary adenoma, but prolactin dynamics did not support an autonomous secretory state. Replacement therapy with thyroxine led to complete reversal of clinical, radiologic, and biochemical abnormalities.- - - - - - - - - - ranking = 1keywords = pituitary (Clic here for more details about this article) |
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