[Male prolactin producing pituitary microadenoma -a case report (author's transl)]

A 27-year-old man was admitted to the Urological Department of Tokyo University, with complaints of delayed puberty and growth retardation. At the age of 14 years, he found his skeletal growth retarded. Since then he had not shown any development of secondary sex characters, such as change of voice, appearance of public and axillary hair and development of external genital organs. He had not experienced the ejaculation and libido, while the excretion has been maintained. This feminized patient showed poorly developed external genitalia, while there was no evidence of galactorrhea or gynecomastia. Ophthalmologic examinations were normal. Endocrinological studies revealed moderate hyperprolactinemia (185-200 ng/ml) and marked disorder for GH secretion. Gonadotropins were low normal and their responses to LH-RH were moderately disturbed. Serum testosterone level was extremely low and its responses to HCG were insufficient. Under the diagnosis of prolactinoma, he was referred to the Neurological Department. Plain skull film and tomography of the sella showed a deformed and slightly expanded sella, the measurement of which were within normal limits. No supra-sellar extention was demonstrated by pneumoencephalography and CT scan. A diagnosis of PRL producing microadenoma was made, and a radical removal of the tumor was performed through the transsphenoidal route. In most tumor cells the presence of PRL was revealed by immunohistochemical stains. Postoperatively, PRL levels returned to normal, while other hormonal deficiencies remained unchanged. With the administration of testosterone, he gradually became masculine and reportedly gained normal libido and potency.