Prolactinoma induced by estrogen and cyproterone acetate in a male-to-female transsexual.
OBJECTIVE
To report a case of a microprolactinoma in a male-to-female transsexual treated with estrogens and cyproterone acetate.


METHODS
Case report.


METHODS
Endocrinology unit in a university hospital.


METHODS
A 33-year-old male-to-female transsexual with prolactin level of 10 ng/mL.


METHODS
Treatment with equine-conjugated estrogens (2.5 mg/day, orally) and cyproterone acetate (100 mg/day, orally) during 6 months.


METHODS
Her levels of prolactin were repeatedly found to be elevated to a maximum of 133 ng/mL, and magnetic resonance imaging (MRI) revealed a pituitary mass of 5x4x4 mm.


RESULTS
Discontinuation of the cross-sex hormone treatment did not reduce the levels of prolactin. The use of dopaminergic-agonist therapy normalized them and reduced the size of the microadenoma. After sex-reassignment surgery, she was treated with low-dose estradiol transdermal patches and presented normal levels of prolactin and appropriate levels of 17beta-estradiol and testosterone with a stable image in MRI.


CONCLUSIONS
We report a case of prolactinoma after treatment with equine-conjugated estrogens and cyproterone acetate. We recommend long-term follow-up observation consisting of a periodic evaluation of prolactin levels and any symptoms suggestive of hyperprolactinemia to detect as early as possible complications derived from cross-sex hormone therapy.
Department of Endocrinology, Doctor Peset University Hospital, Valencia, Spain.
Katherine
K
García-Malpartida
Alejandro
A
Martín-Gorgojo
Milagros
M
Rocha
Marcelino
M
Gómez-Balaguer
Antonio
A
Hernández-Mijares
D000284:Administration, Oral; D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D017373:Cyproterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000139:chemically induced*; D015175:Prolactinoma / Q000139:chemically induced*; D014189:Transsexualism / Q000188:drug therapy*
D000726:Androgen Antagonists; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D017373:Cyproterone Acetate