A 23-year-old woman had suffered from secondary amenorrhea and lactation for a year. A gynecologist prescribed for her a regimen of human-chorionic gonadotropinhuman-menopausal gonadotropin that restored regular menstruation.
Neurologic examination revealed no visual disturbance. She had no features of abnormal pituitary function. Her blood hormone levels were as follows: growth hormone 1.8 (normal <5.0); prolactin 250 (normal <15.0); thyrotropin 1.0 mU/l (normal 0.14.0 mU/l); luteinizing hormone 4.00 IU/l (normal 1567 IU/l); follicle-stimulating hormone 8.50 IU/l (normal 2040 IU/l); A skull radiograph showed slight enlargement of the sella, but no calcification in or around the sella.MR imaging of the brain revealed a cyst in the sella with suprasellar extension.
Symptoms
Galactorrhea ,Amenorrhea ,Infertility ,Decreased libido
Labs
Serum Prolactin > 100 to 200 ng/ml
Radiology
MRI Head with cone-down view of sella turcica
Management (size가 작으면 medical treatment가 우선,tumor growth 가 매우 느리다.)
Macroadenoma (>10 mm in diameter)
A.Suprasellar (may compress optic chiasm)
Infertility: Bromocriptine or Surgery
Amenorrhea: Bromocriptine or Cabergoline or Surgery
B.Intrasellar
Infertility: Bromocriptine
Amenorrhea: Bromocriptine or Cabergoline
Microadenoma (<10 mm in diameter)
No treatment needed if Menses regular
Infertility: Bromocriptine
Amenorrhea Bromocriptine or Cabergoline or Oral Contraceptive
