Ectopic hyperprolactinaemia in a woman with a mesocolic perivascular epithelioid cell tumor ("PEComa").
Ectopic prolactin secretion remains exceptional and originates mainly from malignant tumors. We report the case of a 47-year-old woman who presented amenorrhea leading to unravel important hyperprolactinaemia (269 ng/mL) with no hypothalamo-pituitary mass on magnetic resonance imaging (MRI). Pelvic imaging revealed the presence of a large pelvic mass that originated from the mesocolon. After complete surgical extraction, histological examination was in favour of a "perivascular epithelioid cell tumor" (PEComa). Prolactin levels normalized after surgical extraction and remained normal after a 3-year follow-up, totally free of tumour recurrence and/or metastasis. This suggests that hyperprolactinaemia was most likely related to the PEComa, despite negative reactions with antiprolactin antibodies at immunohistochemistry. Alternatively to a direct prolactin secretion by the tumor, one could hypothesize that the tumour secreted a prolactin stimulating factor or a dopamine antagonist that could not be identified. In conclusion, in face of an important hyperprolactinaemia without any hypothalamic-pituitary mass, it remains important to search for an ectopic prolactin production, such as a PEComa.
Proust-Lemoine
E
E
Service d'endocrinologie et maladies métaboliques, clinique Marc-Linquette, 6, rue du Pr-Laguesse, CHRU de Lille, 59037 Lille cedex, France. e-proust-lemoine@chru-lille.fr
Mitchell
V
V
Deruelle
P
P
Lamblin
A
A
Néraud
B
B
Leroy
X
X
Leteurtre
E
E
Dewailly
D
D
D000568:Amenorrhea / Q000209:etiology; D015622:Epithelioid Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000473:pathology*; D007029:Hypothalamic Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011388:Prolactin / Q000096:biosynthesis / Q000502:physiology; D015175:Prolactinoma / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000473:pathology*
D011388:Prolactin