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A case of macroprolactinoma and elevated insulin-like growth factor-I in a young boy
Ori Eyal1, Lena N Naffaa, Deborah A Elder
1Divisions of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Ohio 45229, USA. ori.eyal@chmcc.org
Unlabelled:
We report a case of a 10-y-old boy who presented with persistent headache and was found to have a giant prolactinoma. Laboratory evaluation revealed markedly elevated prolactin (PRL) level, thyroid-stimulating hormone (TSH) deficiency, and elevated insulin-like growth factor-I (IGF-I). He had normal random growth hormone (GH) but non-suppressible GH during oral glucose tolerance test (OGTT). Cabergoline treatment was initiated and was well tolerated. Therapy successfully reduced PRL levels, normalized IGF-I levels, and reduced tumor size.
Conclusion:
Our patient presented with a GH-PRL-secreting tumor. Dopamine agonists are recommended as the treatment of choice for prolactinomas. However, there should be careful attention to GH status when treating GH-PRL-secreting tumor with dopamine agonists alone. IGF-I levels should be followed in all patients with prolactinoma, even in those with normal basal GH concentrations, because of the possibility of GH co-secretion.
