Dandona P, Mohiuddin J, Lindsay K W
Postgrad Med J. 1984 Aug;60(706):540-1. doi: 10.1136/pgmj.60.706.540.
An 18-year-old boy with delayed puberty was found to have a large prolactinoma. Hypophysectomy led to a fall in serum prolactin concentration, although it remained markedly elevated. The introduction of replacement therapy, including testosterone, resulted in painful swelling of the breasts and galactorrhoea. Bromocriptine therapy resulted in a cessation of galactorrhoea and normalization of serum prolactin concentrations. The absence of galactorrhoea in association with an astronomical concentration of prolactin, and its onset in association with diminished prolactin concentrations following hypophysectomy and the introduction of testosterone therapy, indicate that galactorrhoea requires the presence of high prolactin concentrations to act on mature breast tissue. This would account for the rarity of galactorrhoea in prepubertal children with prolactinomas.
一名青春期延迟的18岁男孩被发现患有大泌乳素瘤。垂体切除术导致血清泌乳素浓度下降，尽管仍显著升高。引入包括睾酮在内的替代疗法后，出现了乳房疼痛性肿胀和溢乳。溴隐亭治疗导致溢乳停止，血清泌乳素浓度恢复正常。泌乳素浓度极高时无溢乳，而在垂体切除术后泌乳素浓度降低并引入睾酮治疗后出现溢乳，这表明溢乳需要高泌乳素浓度作用于成熟乳腺组织。这可以解释患有泌乳素瘤的青春期前儿童中溢乳罕见的原因。
