title: Nonfunctioning pituitary macroadenoma presenting with mild hyperprolactinemia and amenorrhea.
abstract: OBJECTIVE
  To describe a patient with a clinically nonfunctioning pituitary macroadenoma who presented with mild hyperprolactinemia and amenorrhea.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Tertiary care medical facility.
  
  
  METHODS
  A 44-year-old woman with a 6-month history of amenorrhea.
  
  
  METHODS
  Pituitary testing, magnetic resonance imaging of the sella turcica, and transsphenoidal surgery.
  
  
  METHODS
  Pituitary function testing, magnetic resonance imaging, and return of menstrual cycles.
  
  
  RESULTS
  Baseline laboratory data revealed a serum prolactin level of 34 ng/mL (normal range, 3-20 ng/mL), normal thyroid function test results, and an FSH level of 6.7 mIU/mL. A second fasting prolactin level was 48 ng/mL. Magnetic resonance imaging of the sella turcica revealed a pituitary macroadenoma measuring 1.4 x 3.2 cm. Further testing of baseline pituitary function revealed normal findings. The patient underwent an uncomplicated transsphenoidal resection of the pituitary tumor and maintained normal pituitary function. Pathologic evaluation revealed a pituitary adenoma that stained positive for FSH and focally for the alpha subunit. The adenoma stained negative for GH, prolactin, ACTH, LH, and TSH.
  
  
  CONCLUSIONS
  This patient had a nonsecreting gonadotroph macroadenoma that resulted in hypogonadotropic hypogonadism along with mild hyperprolactinemia, presumably secondary to interruption of normal transport down the pituitary stalk.
authors.affiliation: Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Hansen
authors.forename: S P
authors.initials: SP
authors.lastname: Tho
authors.forename: F
authors.initials: F
authors.lastname: Gomez
authors.forename: P G
authors.initials: PG
authors.lastname: McDonough
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008597:Menstrual Cycle; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D012658:Sella Turcica / Q000473:pathology