Transformation of a micro-prolactinoma to a macro-prolactinoma during pregnancy is rare. During treatment of micro-prolactinoma it is conventional to stop dopamine agonist treatment prior to or at conception and only re-image the pituitary if the patient presents with symptoms or signs of pituitary enlargement. We present two cases of micro-prolactinoma transforming to macro-prolactinoma during pregnancy. Neither case presented with symptoms or signs of pituitary enlargement. In Case 1, the pituitary was re-imaged because the patient's general practitioner inadvertently measured serum prolactin during pregnancy and it was found to be massively elevated. In Case 2, the pituitary was re-imaged because of patient anxiety. She suffers from migraine and episodes of migrainous headache were no more frequent during pregnancy than previously. These cases raise concern about conventional recommendations that the pituitary in cases of micro-prolactinoma should only be re-imaged during pregnancy if the patient presents with symptoms or signs of pituitary enlargement.
22 - 24 Mar 2004
British Endocrine Societies