Nonfunctioning pituitary macroadenoma presenting with mild hyperprolactinemia and amenorrhea

Keith A. Hansen, Sandra P.T. Tho, Fernando Gomez, Paul G. McDonough

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To describe a patient with a clinically nonfunctioning pituitary macroadenoma who presented with mild hyperprolactinemia and amenorrhea. Design: Case report. Setting: Tertiary care medical facility. Patient(s): A 44-year-old woman with a 6-month history of amenorrhea. Intervention(s): Pituitary testing, magnetic resonance imaging of the sella turcica, and transsphenoidal surgery. Main Outcome Measure(s): Pituitary function testing, magnetic resonance imaging, and return of menstrual cycles. Result(s): Baseline laboratory data revealed a serum prolactin level of 34 ng/mL (normal range, 3-20 ng/mL), normal thyroid function test results, and an FSH level of 6.7 mIU/mL. A second fasting prolactin level was 48 ng/mL. Magnetic resonance imaging of the sella turcica revealed a pituitary macroadenoma measuring 1.4 x 3.2 cm. Further testing of baseline pituitary function revealed normal findings. The patient underwent an uncomplicated transsphenoidal resection of the pituitary tumor and maintained normal pituitary function. Pathologic evaluation revealed a pituitary adenoma that stained positive for FSH and focally for the α subunit. The adenoma stained negative for GH, prolactin, ACTH, LH, and TSH. Conclusion(s): This patient had a nonsecreting gonadotroph macroadenoma that resulted in hypogonadotropic hypogonadism along with mild hyperprolactinemia, presumably secondary to interruption of normal transport down the pituitary stalk.

Original languageEnglish (US)
Pages (from-to)663-665
Number of pages3
JournalFertility and sterility
Volume72
Issue number4
DOIs
StatePublished - Oct 1999

Keywords

  • Gonadotroph adenoma
  • Hyperprolactinemia
  • Hypogonadism

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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