Sachdev Saachi, Reyes Maria Carolina, Snyder Peter J
Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Phildelphia, PA.
J Endocr Soc. 2020 Mar 16;4(4):bvaa035. doi: 10.1210/jendso/bvaa035. eCollection 2020 Apr 1.
Ectopic hormone production is well recognized, but ectopic production of prolactin has been reported infrequently. We report here the case of a 47-year-old woman who had hyperprolactinemia (213-224 ng/mL) causing galactorrhea and hypogonadism. Cabergoline treatment, 1.0 mg twice a week, did not lower the prolactin level at all, but excision of a large uterine leiomyoma corrected the hyperprolactinemia and the hypogonadism. The excised leiomyoma tissue exhibited immunostaining for prolactin, confirming by this method for the first time that a uterine leiomyoma was the cause of hyperprolactinemia. This case illustrates the need to consider an ectopic source of prolactin in a patient who has hyperprolactinemia that is not associated with a large sellar mass and is completely resistant to cabergoline.
异位激素分泌已得到充分认识，但异位分泌催乳素的报道却很少见。我们在此报告一例47岁女性，她患有高催乳素血症（213 - 224 ng/mL），导致溢乳和性腺功能减退。每周两次服用1.0 mg卡麦角林治疗，催乳素水平完全没有降低，但切除一个大的子宫平滑肌瘤后，高催乳素血症和性腺功能减退得到了纠正。切除的平滑肌瘤组织显示催乳素免疫染色阳性，首次通过这种方法证实子宫平滑肌瘤是高催乳素血症的病因。该病例表明，对于高催乳素血症患者，如果其与鞍区大肿块无关且对卡麦角林完全耐药，需要考虑催乳素的异位来源。
