1/71. Large empty sella with an intrasellar herniation of an elongated third ventricle. Case report.A 73-year-old female presented with a large empty sella with herniation of an elongated third ventricle concomitant with herniation of the surrounding subarachnoid space into the sella, manifesting as visual impairment and amenorrhea without galactorrhea. magnetic resonance imaging and computed tomography cisternography clearly showed the large empty sella, without evidence of either hydrocephalus or benign intracranial hypertension, which is extremely rare.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
2/71. Spontaneous remission in idiopathic hyperprolactinemia.In this report we describe a 37 year old lady who was demonstrated to have hyperprolactinemia causing amenorrhea-galactorrhea syndrome. Computerized tomography scan done twice did not reveal any sellar or suprasellar abnormality and there was no clinical or biochemical evidence of primary hypothyroidism. She had regression of galactorrhea, resumed regular menstrual cycles, and conceived twice on bromocriptine therapy. Following her second delivery she noticed spontaneous remission of galactorrhea and, prolactin levels estimated multiple times were normal.- - - - - - - - - - ranking = 3keywords = galactorrhea (Clic here for more details about this article) |
3/71. Pituitary function testing in amenorrhea-galactorrhea-hyperprolactinemia.Fifteen patients, age 16 to 55, presented with amenorrhea-galactorrhea-hyperprolactinemia. Pituitary function was evaluated by bolus injections of insulin, luteinizing hormone-releasing hormone (LHRH), and thyrotropin-releasing hormone (TRH) in 13 and by LHRH and TRH in 2. Responses to growth hormone (GH), thyroid-stimulating hormone (TSH), cortisol (F), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin were measured. GH, TSH, and F responses were normal in most cases. LH responses were decreased (P less than 0.025) in patients with abnormal sellar tomography, whereas FSH responses tended to decrease with elevated prolactin levels. Prolactin responses were absent in five of the seven cases which could be evaluated. The clinical value of such testing appears to be limited to an individualized basis, although some prognosis of ovulatory response to bromocriptine therapy may be obtained from the gonadotropin response.- - - - - - - - - - ranking = 5keywords = galactorrhea (Clic here for more details about this article) |
4/71. amenorrhea-galactorrhea syndrome as an uncommon manifestation of isolated neurosarcoidosis.The involvement of the hypothalamic and/or the pituitary gland during granulomatous, infiltrative or autoimmune diseases is a rare condition of acquired hypothalamic dysfunction and non-tumoral-non-vascular hypopituitarism. sarcoidosis is a pathogen-free granulomatous disease which affects both central and peripheral nervous systems in 5-16% of patients. In most cases, nervous involvement by sarcoidosis occurs within a multi-systemic disease, although disease localization limited to the nervous system has also been reported. We observed a 26-year-old Italian woman presenting with low-grade fever, headache, visual disturbances, amenorrhea-galactorrhea syndrome and pituitary failure due to an infiltrative lesion involving the hypothalamus and the pituitary stalk. At first, the diagnosis of "probable" neurosarcoidosis was made according to the clinical picture, magnetic resonance imaging, and the study of cerebrospinal fluid lymphocyte sub-populations. In this case, hyperprolactinemic amenorrhea and galactorrhea combined with blunted responses of gonadotropins to luteinizing hormone releasing hormone and acquired growth hormone failure were to be considered as an infrequent manifestation of neurosarcoidosis limited to the medio-basal brain, without other disease localization. Forty-eight months after disease onset, the occurrence of mediastinal lymph node enlargement and increase of angiotensin converting enzyme in serum allowed us to confirm the diagnosis of sarcoidosis. Neurosarcoidosis is often hard to diagnose, especially when the neurological localization of the disease is not accompanied by other possible systemic signs, and when the lesion is too deep to obtain biopsy confirmation. The study of cerebrospinal fluid and blood lymphocyte sub-populations integrated by magnetic resonance imaging may be helpful for a correct diagnosis.- - - - - - - - - - ranking = 6keywords = galactorrhea (Clic here for more details about this article) |
5/71. Primary amenorrhea-galactorrhea with hyperprolactinemia and huge pituitary enlargement in juvenile primary hypothyroidism.We report a girl with juvenile primary hypothyroidism revealed by growth retardation and a syndrome of primary amenorrhea-galactorrhea with hyperprolactinemia and suprasellar pituitary enlargement. Resolution of the pituitary enlargement and the amenorrhea-galactorrhea syndrome occurred after thyroid hormone replacement. No similar observation has been reported earlier in juvenile hypothyroidism.- - - - - - - - - - ranking = 6keywords = galactorrhea (Clic here for more details about this article) |
6/71. hypopituitarism and amenorrhea-galactorrhea syndrome caused by thrombosis of both internal carotid artery and giant intrasellar aneurysm: case report.Giant intra and parasellar aneurysm with a spontaneous thrombosis of internal carotid artery is rare. We report the case of a 34 years old woman presenting a unique giant sellar and parasellar aneurysm associated with hypopituitarism and amenorrhea-galactorrhea syndrome. Computed tomographic scans and magnetic resonance images were suggestive of a sellar tumor with a cystic component. Digital cerebral angiography showed spontaneous thrombosis of a intrasellar and parasellar carotid artery aneurysm and left internal carotid artery in the neck. A transseptal endoscopic biopsy was done and confirmed a thrombosed aneurysm. No other surgical treatment was required in this patient but permanent endocrinological treatment was necessary.- - - - - - - - - - ranking = 5keywords = galactorrhea (Clic here for more details about this article) |
7/71. Cushing's disease arising from a clinically nonfunctioning pituitary adenoma.A 49-yr-old woman with a large pituitary tumor leading to visual loss and galactorrhea- amenorrhea was submitted to transcranial pituitary surgery, when a clinically nonfunctioning pituitary adenoma was partially removed. Histopathology and immunohistochemistry confirmed the diagnosis of "non-secreting atypical adenoma." At that time, serum and urinary free cortisol were normal, with low T4 levels and hyperprolactinemia. The patient was discharged on thyroxine and bromocriptine and treated with conventional radiotherapy. Two years later, she presented high free urinary cortisol levels and a positive ACTH response to desmopressin testing on dexametasone 2 mg overnight. A pituitary biopsy confirmed aggressive growth as well as positive immunoreactivity for ACTH, p53, Ki-67, and c-erb-B2. The patient was then treated with radiosurgery on ketoconazole therapy. The overall clinical, laboratory, and pathological data suggest a transition from a clinically nonfunctioning to a hypersecreting ACTH-producing tumor. Putative mechanisms of tumor transformation and the possibility of a silent corticotropinoma evolving into clinical Cushing s syndrome are discussed.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
8/71. Somatotropic adenomas without acromegaly.Seventeen somatotropic adenomas removed from patients without acromegaly were studied. Thirteen of them presented as a prolactinoma with amenorrhea and/or galactorrhea and elevated serum PRL levels. According to basal serum GH levels, the patients were divided into two groups, namely Group I: GH slightly elevated (n = 4) and group II: GH less than or equal to 5 micrograms/l (n = 13). The tumoral GH secretion was proved by immunocytochemistry in all cases and by intratumoral RIA, in vitro study and/or in situ hybridization in five of them. Pathological, clinical and biochemical relationships suggested two anatomoclinical aspects. In group I, the tumors were small, well-differentiated somatotropic adenomas with clinically silent GH hypersecretion. It is probably an early stage of the disease. In group II, the tumors were large with normal GH serum levels. They were poorly differentiated and secreted very low amounts of GH. In nine of them, PRL and/or PRL mRNA expression were also detected. These tumors do not secrete enough GH to increase serum levels and cause acromegaly. The somatotropic adenomas without acromegaly correspond to two anatomoclinical aspects of the disease.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
9/71. osteoporosis associated with neuroleptic treatment. A case report.A 28-year-old woman developed osteoporosis following seven years of neuroleptic use. She presented with amenorrhea and profuse galactorrhea of four years' duration. Dual photon absorptionometry demonstrated reduced bone mineral density in the femur and spine. serum calcium, phosphorus and alkaline phosphatase were normal. The patient was started on bromocriptine, and her bone density, serum prolactin, dehydroepiandrosterone sulfate, and free and total testosterone improved. No deterioration in her psychiatric condition occurred.- - - - - - - - - - ranking = 1keywords = galactorrhea (Clic here for more details about this article) |
10/71. hyperprolactinemia, galactorrhea and amenorrhea in women with a spinal cord injury.Six women with a traumatic spinal cord injury (SCI) developed hyperprolactinemia, amenorrhea and galactorrhea. Five of them had thoracic level lesions and 1 had a lumbosacral lesion. Two were postpartum and 1 was pregnant at the time of injury. Transient diabetes insipidus developed in 1 patient. Temporary administration of bromocriptine decreased prolactin levels, caused cessation of lactation and restored ovulatory cycles. The syndrome disappeared spontaneously in all 6 patients. Pituitary stalk concussion resulting from the trauma might cause this phenomenon, with the level of the cord injury playing a role. Being pregnant or early postpartum can predispose women to develop this syndrome.- - - - - - - - - - ranking = 5keywords = galactorrhea (Clic here for more details about this article) |
| | Next -> |