Acromegaly with moderate hyperprolactinemia caused by an intrasellar macroadenoma.
BACKGROUND
A 31-year-old woman presented 12 months after discontinuing the oral contraceptive pill with progressive headache to her primary-care physician. She had previously presented with irregular menses to her obstetrician-gynecologist 4 months after discontinuing the oral contraceptive pill. Her serum prolactin levels were 153 microg/l and a pituitary MRI revealed a 13 mm intrasellar mass consistent with an adenoma. The patient was given 0.5 mg cabergoline twice weekly, and after 6 weeks her prolactin levels fell to 31 microg/l. After 6 months, however, she complained of persistent frontal headache and a repeat MRI revealed that the adenoma had increased in size to 16 mm. The patient was referred to an endocrinologist for further evaluation.


METHODS
Serum insulin-like growth factor 1 levels and growth hormone levels measured 2 h after ingestion of 75 g of oral glucose.


METHODS
Acromegaly and hyperprolactinemia caused by a mixed-cell adenoma, secreting growth hormone and prolactin.


RESULTS
Trans-sphenoidal surgery followed by medical therapy with 20 mg intramuscular octreotide-LAR monthly.
Bonert
Vivien S
VS
Cedars Sinai Medical Center, Los Angeles, CA, USA.
Melmed
Shlomo
S
D000172:Acromegaly / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012658:Sella Turcica / Q000473:pathology