Cabergoline Effectively Induced Remission of Prolactinoma in a 9-year-old Japanese Boy.
Prolactinomas are rarely diagnosed in children under the age of 10. A 9-yr-old Japanese boy complained of severe headache and progressive visual disturbance. His growth had been retarded for approximately 3 yr, and his serum PRL level was 811.6 ng/ml. Brain magnetic resonance imaging (MRI) revealed an enlarged pituitary (2.8 × 2.6 × 2.1 cm) with heterogeneous enhancement. He was diagnosed as having a macroprolactinoma accompanied by pituitary apoplexy and growth hormone deficiency. A surgical approach was initially undertaken due to the progressive visual deficits, but a residual tumor was observed, and the level of serum PRL was still high after the surgery. Cabergoline was then started, and the dose was gradually increased to 1.5 mg/wk. The serum PRL level decreased from 138.8 ng/ml to 32.5 ng/ml and 17.7 ng/ml after 5 wk and 19 wk, respectively. At 33 wk of cabergoline treatment, brain MRI demonstrated no evidence of the residual tumor. Thereafter, the serum level of PRL decreased to less than 10 ng/ml, and remission was consistently confirmed on repeated MRI. No adverse events have been observed. The present case suggests that cabergoline can be an effective treatment for prolactinomas in prepubertal children as well as in adults.
Department of Pediatrics, Sapporo City General Hospital, Sapporo, Japan.
Hitomi
H
Sano
Department of Neurosurgery, Sapporo City General Hospital, Sapporo, Japan.
Masayoshi
M
Takigami
Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.
Tetsuo
T
Ogino
Department of Pediatrics, Sapporo City General Hospital, Sapporo, Japan.
Keita
K
Morioka
Department of Pediatrics, Sapporo City General Hospital, Sapporo, Japan.
Tomoshiro
T
Ito
Department of Pediatrics, Sapporo City General Hospital, Sapporo, Japan.
Akira
A
Sudo
Department of Pediatrics, Sapporo City General Hospital, Sapporo, Japan.
Naoki
N
Fukushima
cabergoline; growth hormone; pituitary apoplexy; prolactinoma