Massive prolactinoma with galactorrhoea in a prepubertal boy

Area of Science:

• Pediatric Endocrinology
• Neuro-oncology

Background:

• Prolactinomas, pituitary tumors secreting prolactin, are rare in children.
• Galactorrhea, or abnormal milk production, is an uncommon symptom in prepubertal children.

Observation:

• An 8-year-old prepubertal boy presented with symptoms of increased intracranial pressure, left proptosis (bulging eye), and galactorrhea.
• Cranial computerized tomography revealed a large pituitary tumor invading the cavernous sinus and left orbit.

Findings:

• Serum prolactin levels were significantly elevated at 180,600 mU/l (normal <360 mU/l).
• This case represents a rare occurrence of prolactinoma with galactorrhea in a prepubertal child.
• The massive prolactinoma demonstrated an impressive response to a combined treatment regimen.

Implications:

• Highlights the importance of considering rare pituitary tumors in pediatric patients with atypical presentations.
• Demonstrates the efficacy of a multidisciplinary treatment approach for massive prolactinomas in children.
• Suggests that galactorrhea may be a presenting symptom of prolactinomas even in prepubertal males.