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Rapid regression through bromocriptine therapy of a suprasellar extending prolactinoma during pregnancy
Author(s) -
Tan Seang Lin,
Jacobs Howard S.
Publication year - 1986
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(86)90099-8
Subject(s) - bromocriptine , prolactinoma , medicine , galactorrhea , pregnancy , amenorrhea , prolactin , pituitary tumors , surgery , pituitary neoplasm , pituitary gland , gynecology , hormone , biology , genetics
A 29‐year‐old woman is described who presented with amennorrhea and galactorrhea with a large prolactinoma which regressed on bromocriptine therapy. Treatment with bromocriptine was stopped when pregnancy was diagnosed but 6 weeks later the prolactinoma had regrown with suprasellar extension and lateral invasion of the cavernous sinus. When treatment with bromocriptine was reinstituted symptoms subsided within 24 h and serum prolactin concentrations fell from 54,000 mM/l to 2800 mU/l within 5 days and 500 mU/l 2 days after that. Pregnancy proceeded without complications and she entered spontaneous labor at term and delivered a healthy baby. One year after delivery, on treatment with bromocriptine, her serum prolactin concentration remains within the normal range and the CT scan shows persistence of a small prolactinoma, confined to the pituitary fossa. Bromocriptine should be the primary treatment for prolactinomas regardless of tumor size and may be safely stopped when pregnancy is desired. If pituitary tumor complications occur during pregnancy, reintroduction of treatment with bromocriptine should again be the treatment of choice.