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Bromocriptine-unresponsive prolactin macroadenoma in a prepubertal female
K L Cheyne1, E S Lightner, G D Comerci
1Department of Pediatrics, University of Arizona, Tuscon 85724.
Summary
Macroprolactinomas are rare in children. This case highlights a prepubertal girl with a macroprolactinoma presenting with anorexia nervosa, requiring a multimodal treatment approach.
Area of Science:
- Pediatric Endocrinology
- Neuroendocrinology
- Oncology
Background:
- Macroprolactinomas, rare pituitary tumors, present unique challenges in prepubertal children.
- Early diagnosis and management are crucial for optimal outcomes.
Observation:
- A prepubertal female presented with symptoms mimicking anorexia nervosa, including severe headaches, anorexia, weight loss, and growth failure.
- Initial serum prolactin levels were significantly elevated at 2,916 ng/ml.
Findings:
- Bromocriptine treatment initially lowered prolactin levels, but levels subsequently increased despite dose escalation.
- The patient underwent successful transsphenoidal surgical resection followed by adjuvant radiation therapy.
Implications:
- This case underscores the importance of considering pituitary tumors in the differential diagnosis of eating disorders and growth failure in children.
- Multimodal therapy, including pharmacotherapy, surgery, and radiation, may be necessary for managing pediatric macroprolactinomas.
- Further research into optimal treatment strategies for pediatric macroprolactinomas is warranted.