Ege University Medical Faculty, Deparment of Internal Medicine, Division of Endocrinology and Metabolism, Izmir, Turkey.
Gynecol Endocrinol. 2012 Feb;28(2):148-9. doi: 10.3109/09513590.2011.589923. Epub 2011 Jul 23.
A 34-year-old female presented to our clinic with a 1.5 year history of secondary amenorrhea and galactorrhea. Prolactin (PRL) level was found to be 151.89 ng/ml. Pituitary imaging was reported to be normal. An examination of the patient revealed that PRL level was still high so the dose of cabergoline was further increased and subsequently, bromocriptine was added to the treatment. There was no reduction in PRL levels in controls. A scanning was performed to look for an ectopic focus. Abdominal computerized tomography revealed a heterogenous mass lesion originating from the uterus. Octreotide scintigraphy was performed and we observed an involvement consistent with the mass in the uterus. The patient underwent abdominal total hysterectomy. PRL dropped to 0.4 ng/ml the next day after the operation. The pathology result was a low-grade malignant mesenchymal tumor. Prolactin was found to be immunohistochemically negative. However, galactorrhea disappeared postoperative and PRL levels are still low. Elevated levels of PRL, resistant to bromocriptine and cabergoline, rapidly returned to normal after hysterectomy, which obviously indicates that hyperprolactinemia was associated with the myoma of the uterus.
一位 34 岁女性因继发性闭经和溢乳就诊，病史 1.5 年。催乳素（PRL）水平发现为 151.89ng/ml。垂体影像学报告正常。对患者的检查显示 PRL 水平仍然很高，因此卡麦角林的剂量进一步增加，随后添加了溴隐亭进行治疗。对照中 PRL 水平没有降低。进行扫描以寻找异位灶。腹部计算机断层扫描显示源自子宫的混杂肿块病变。进行奥曲肽闪烁显像，我们观察到与子宫内肿块一致的受累情况。患者接受了腹部全子宫切除术。术后第二天 PRL 降至 0.4ng/ml。病理结果为低度恶性间质瘤。免疫组化显示催乳素阴性。然而，术后溢乳消失，PRL 水平仍然较低。升高的 PRL 水平对溴隐亭和卡麦角林耐药，术后迅速恢复正常，这显然表明高催乳素血症与子宫肌瘤有关。
