[A case of male prolactinoma presenting extremely high serum prolactin levels and biphasic response to CB-154 suppression test].
A 33-year-old male was admitted to the Department of Neurosurgery, Fukui Medical School with a complaint of headache. There were no neurological deficits on admission. Craniogram demonstrated a so-called "phantom sella". A computed tomography revealed a high density mass lesion and the mass was enhanced well, that mainly extended from the sella to the left middle cranial fossa. The left carotid angiogram revealed an avascular mass lesion extending from the sella to the left middle cranial fossa. Pituitary function tests revealed an extremely high serum prolactin (PRL) levels (70, 100 ng/ml). PRL response to TRH was delayed in peak and the high level continued. Serum PRL levels elevated to 90, 800 ng/ml at 180 min after injection of TRH. A biphasic response was demonstrated in response to CB-154 suppression test to PRL secretion, that is, CB-154 stimulated PRL release initially (up to 90 min) and suppressed thereafter. Serum PRL levels (178, 400 ng/ml) reached to peak about 90 min after CB-154 administration. Response of growth hormone (GH) and adrenocorticotropic hormone (ACTH) to insulin were also impaired. Craniotomy was performed. The tumor was partially removed and was diagnosed as a prolactinoma histologically. Tumor tissue removed was subjected to the monolayer culture and electron microscopic study. Their observations demonstrated hyperactive PRL secretion of the individual cells. A total dose of 5,000 rads was irradiated postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
D000236:Adenoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D000328:Adult; D001971:Bromocriptine; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
D001971:Bromocriptine; D011388:Prolactin