Tabatabaei Fatemeh, Sharif Mohammad Reza, Nasr Esfahani Hossein, Yazdi Zahrani Razieh, Taheri Abolfazl, Meamar Rokhsareh
Clinical Research Development Research Centre, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
J Res Med Sci. 2020 Nov 26;25:108. doi: 10.4103/jrms.JRMS_118_20. eCollection 2020.
Prolactinoma is a rare tumor of childhood. Clinical presentations of prolactinoma include amenorrhea, delayed puberty, and galactorrhea. For the first time, in this case, elevated prolactin levels were associated with unexpected premature pubarche. We describe an 8-year, 7-month-old boy with acne and gradual appearance of pubic hair, corresponding to tanner stage 2. Hormonal tests showed severe hyperprolactinemia (prolactin = 246.8 μg/L and pooled prolactin = 175 μg/L and macroprolactin = 5 μg/L) and mildly elevated level of dehdroepiandrostenedion sulfate (DHEAS) and testosterone. Magnetic resonance imaging (MRI) findings confirmed the presence of a pituitary macroprolactinoma, measuring 14 mm × 12 mm × 8 mm on the right side of the pituitary gland. Cabergoline therapy was commenced (0.5 mg/week) and after 3 months, no evidence of pubarche progression was observed. Prolactin level and tumor size markedly reduced. At the 9-month follow-up visit, a normal MRI was reported. This case highlights that even when facing premature pubarche, careful examination is mandatory, and if no obvious etiology is found for premature pubarche, clinicians should consider prolactinoma.
催乳素瘤是一种罕见的儿童肿瘤。催乳素瘤的临床表现包括闭经、青春期延迟和溢乳。在本病例中，催乳素水平升高首次与意外的青春期过早出现相关。我们描述了一名8岁7个月大的男孩，有痤疮且阴毛逐渐出现，对应坦纳2期。激素检测显示严重高催乳素血症（催乳素 = 246.8 μg/L，总催乳素 = 175 μg/L，大催乳素 = 5 μg/L），硫酸脱氢表雄酮（DHEAS）和睾酮水平轻度升高。磁共振成像（MRI）结果证实存在垂体大催乳素瘤，位于垂体右侧，大小为14 mm×12 mm×8 mm。开始使用卡麦角林治疗（0.5 mg/周），3个月后，未观察到阴毛生长进展的迹象。催乳素水平和肿瘤大小明显降低。在9个月的随访中，报告MRI正常。该病例强调，即使面对青春期过早出现，仔细检查也是必要的，如果未发现青春期过早出现的明显病因，临床医生应考虑催乳素瘤。
