Menon Lakshmi P, Edem Dinesh
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
SAGE Open Med Case Rep. 2023 Jul 31;11:2050313X231190672. doi: 10.1177/2050313X231190672. eCollection 2023.
Hypogonadotropic hypogonadism is a common finding in patients who are diagnosed with a prolactinoma. It can be accompanied by the presence of other pituitary hormone deficits, including secondary adrenal insufficiency and central hypothyroidism. While the proportion of improvement in endocrine deficits over the short term is well characterized, there is not enough literature about the recovery of pituitary function over the longer term. We present the case of a 23-year-old man with a giant prolactinoma who initially presented with pituitary hemorrhage and panhypopituitarism. He underwent decompression of the pituitary tumor followed by treatment with cabergoline. Over a 9-year follow-up period, we noted that the hypogonadotropic hypogonadism resolved after 4 years and the secondary adrenal insufficiency resolved after 8 years. This case suggests that partial or complete recovery of the pituitary function is possible over the long-term even in patients with a giant prolactinoma.
低促性腺激素性性腺功能减退是诊断为泌乳素瘤的患者中的常见表现。它可能伴有其他垂体激素缺乏，包括继发性肾上腺功能不全和中枢性甲状腺功能减退。虽然短期内内分泌缺陷改善的比例已有充分描述，但关于长期垂体功能恢复的文献并不充分。我们报告一例23岁患有巨大泌乳素瘤的男性患者，最初表现为垂体出血和全垂体功能减退。他接受了垂体肿瘤减压术，随后使用卡麦角林治疗。在9年的随访期内，我们注意到低促性腺激素性性腺功能减退在4年后得到缓解，继发性肾上腺功能不全在8年后得到缓解。该病例表明，即使是患有巨大泌乳素瘤的患者长期垂体功能也可能部分或完全恢复。
