[Prolactin adenoma developed during puberty. Diagnosis and long-term course. 9 cases].
Nine patients (2 boys, 7 girls) with prolactinomas diagnosed at puberty were followed for 2 to 20 years. The presenting signs were sexual infantilism (n = 2), amenorrhea-galactorrhea (n = 6) and hypogonadism (n = 1). Growth retardation was also present in 3 cases. The pituitary tumor induced endocranial manifestations in only 2 cases, whereas a suprasellar extension was found in 5 cases with visual field defects in 2 cases. Initial prolactin levels ranged between 132 and 2,400 ng/ml and were unresponsive to TRH (n = 6/7). The hormonal work-up showed decreased GH (n = 4/4); LH, FSH (n = 9/9) or ACTH, TSH (n = 1/9) functions. Seven patients underwent trans-sphenoidal adenomectomy associated with dopaminergic agonist treatment. Two patients were treated with bromocriptine. In the long term, clinical signs (n = 6), hyperprolactinemia (n = 7) or prolactinoma (n = 4) persisted or recurred. These data stress the severity of this disease at this period of life, the therapeutic difficulties and the need for long term follow up of these patients.
Clinique des Maladies endocriniennes et métaboliques, Hôpital Cochin, Paris.
L
L
Billaud
I
I
Cousin
B
B
Guilhaume
J P
JP
Luton
D000293:Adolescent; D001971:Bromocriptine / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D015175:Prolactinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D011627:Puberty; D013997:Time Factors
D001971:Bromocriptine
Adénomes à prolactine développés pendant la puberté. Diagnostic et évolution à long terme. 9 observations.