Haney A F, McCarty K S, Hammond C B
J Reprod Med. 1984 Dec;29(12):883-7.
In women with galactorrhea, amenorrhea/oligomenorrhea, hyperprolactinemia and radiographic evidence of a pituitary tumor, the presumed etiology is usually a primary prolactin-secreting tumor. We treated two patients whose presenting symptoms (galactorrhea and oligomenorrhea) and initial investigation (which showed radiographic enlargement of the sella and hyperprolactinemia) suggested a prolactin-secreting pituitary tumor. However, after further endocrinologic investigation, transsphenoidal exploration and ultrastructural-immunohistologic evaluation of the excised pituitary tumors, the tumors were found to be composed of cells characteristic of growth-hormone and adrenocorticotropic-hormone production. These data are consistent with the hypothesis that any factor or factors increasing intrasellar pressure, including pituitary tumors originating in cells other than galactotrophs, can elevate serum prolactin and present clinically as galactorrhea-amenorrhea. They suggest further that a diligent search be done for elevations of other pituitary trophic hormones when a pituitary tumor is suspected in order not to overlook other kinds of serious endocrinopathy.
对于患有溢乳、闭经/月经过少、高催乳素血症且有垂体瘤影像学证据的女性，推测病因通常是原发性催乳素分泌瘤。我们治疗了两名患者，其出现的症状（溢乳和月经过少）及初步检查（显示蝶鞍增大和高催乳素血症）提示为催乳素分泌性垂体瘤。然而，经过进一步的内分泌学检查、经蝶窦探查以及对切除的垂体瘤进行超微结构 - 免疫组织学评估后，发现肿瘤由具有生长激素和促肾上腺皮质激素分泌特征的细胞组成。这些数据与以下假设一致，即任何增加鞍内压力的因素，包括起源于除催乳素细胞以外的细胞的垂体瘤，都可使血清催乳素升高并临床上表现为溢乳 - 闭经。它们还进一步表明，当怀疑有垂体瘤时，应仔细检查其他垂体促激素水平，以免忽视其他类型的严重内分泌病。
