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Estrogen-induced prolactinoma in a man
L J Gooren1, J Assies, H Asscheman
1Department of Endocrinology/Andrology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
The Journal of Clinical Endocrinology and Metabolism
|February 1, 1988
Summary
Pharmacological doses of estrogen can induce prolactinomas in men. This case study highlights a male-to-female transsexual who developed a prolactinoma after estrogen therapy, emphasizing the need for patient monitoring.
Area of Science:
- Endocrinology
- Oncology
- Reproductive Medicine
Background:
- Estrogen-induced prolactinomas are known in rats.
- The potential for estrogen to induce prolactinomas in humans remains unclear.
- This study investigates a human case of estrogen-induced pituitary tumor.
Observation:
- A 26-year-old male-to-female transsexual developed a prolactinoma during 10 months of estrogen therapy (ethinyl estradiol and estradiol-17-undecanoate).
- Plasma prolactin (PRL) levels increased from 0.05 to 5.20 U/L, with a pituitary mass detected on CT scan.
- Following estrogen cessation, PRL levels initially rose further before decreasing with bromocriptine treatment, but later increased again, indicating autonomous secretion.
Findings:
- Pharmacological doses of estrogen can induce prolactinomas in humans.
- Estrogen therapy led to significant elevations in plasma PRL and pituitary tumor development.
- The prolactinoma exhibited autonomous PRL secretion after treatment withdrawal.
Implications:
- High-dose estrogen therapy in individuals requires vigilant monitoring for prolactinoma development.
- This finding necessitates routine screening for pituitary tumors in patients undergoing prolonged estrogen treatment.
- Understanding estrogen's role in pituitary tumorigenesis is crucial for clinical practice and patient safety.