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Massive prolactinoma with galactorrhoea in a prepubertal boy
R J Ross1, J M McEniery, A Grossman
1Department of Endocrinology, St Bartholomew's Hospital, London, UK.
Postgraduate Medical Journal
|June 1, 1989
Summary
A rare case of a massive prolactinoma in a prepubertal boy presented with unusual symptoms. Effective management involved a multimodal approach including surgery, dopamine agonists, and radiotherapy.
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.