Selvan Chitra, Dutta Deep, Ghosh Sujoy, Mukhopadhyay Satinath, Chowdhury Subhankar
Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S132-4. doi: 10.4103/2230-8210.119532.
Macroprolactinoma are rare in childhood, especially in the first decade. A 9-year-old girl presented with headache, vomiting, and decreased vision for 8 months. A diagnosis of macroprolactinoma was made following documentation of elevated serum prolactin (958 ng/ml) with a contrast enhancing macroadenoma (30 × 27 × 28 mm) on magnetic resonance imaging of pituitary. Anterior pituitary function was normal. Cabergoline therapy resulted in resolution of all symptoms in 2-8 months. Revaluation at 10 months of cabergoline therapy revealed normal serum prolactin (14 ng/ml), normal pituitary function, with 91% decrease in adenoma size (11.5 × 13.6 × 12.7 mm). Evaluation at 36 months of cabergoline therapy for growth arrest and weight gain for past 6 months revealed low serum prolactin, growth hormone deficiency, and secondary hypothyroidism with empty sella. She had biochemical as well as structural resolution of prolactinoma. This report highlights the development of multiple pituitary hormone deficiency with empty sella, an uncommon side effect of cabergoline therapy for macroprolactinoma.
巨大泌乳素瘤在儿童期罕见，尤其是在第一个十年。一名9岁女孩出现头痛、呕吐和视力下降8个月。在磁共振成像显示垂体有增强造影的大腺瘤（30×27×28mm）且血清泌乳素升高（958ng/ml）后，诊断为巨大泌乳素瘤。垂体前叶功能正常。卡麦角林治疗在2至8个月内使所有症状消退。卡麦角林治疗10个月时复查显示血清泌乳素正常（14ng/ml），垂体功能正常，腺瘤大小减小91%（11.5×13.6×12.7mm）。卡麦角林治疗36个月时，针对过去6个月的生长停滞和体重增加进行评估，发现血清泌乳素低、生长激素缺乏以及伴有空蝶鞍的继发性甲状腺功能减退。她的泌乳素瘤在生化及结构上均已消退。本报告强调了伴有空蝶鞍的多种垂体激素缺乏的发生，这是卡麦角林治疗巨大泌乳素瘤一种不常见的副作用。
