ABSTRACT

Hyperprolactinemia is a rare disease in childhood which can originate from pituitary adenomas. Sixteen years old girl was admitted with complaints of amenorrhea and galactorrhea from left breast. On physical examination thyroid gland was nonpalpable and galactorrhea from left breast is detected. Laboratory evaluations revealed that, Thyroid Stimulating Hormone (TSH)=3.13 uIU/ml (0.5-5 uIU/ml), free T4=0.73 ng/dl (0.71-1.85 ng/dl), Follicule Stimulating Hormone (FSH)=10.7 mIU/ml (4-13 mIU/ml, follicular phase), Luteinising Hormone (LH)=8.45 mIU/ml, Prolaktin=227.9 ng/mL (5.18-26.53 ng/ml). Pituitary magnetic resonance imaging showed a macroadenoma about 20x15 mm extending to optic chiasm, enlarging sellaturcica and obliterating suprasellarcisterna. Serum levels of cortisole =14 mcg/dl (<20 mcg/dl), growth hormone=2.86 mIU/ml (0-20 mIU/ml), Adrenocorticotropic Hormone (ACTH)=24.7 pg/ml (0-100 pg/ml). There was no bitemporal defect in visual area examination. On neurosurgical consultation,there was no neccesity for surgical intervention and cabergoline treatment was initiated. Galactorrhea was resolved on the second day of treatment,and prolactin level decreased to 14.84 ng/ml on 7th day. Pituitary magnetic resonance imaging showed shrinkage in size of adenoma on 20th day. In conclusion, medical treatment of prolactinoma in childhood may have satisfying response; so that medical treatment should be tried before surgical intervention.