Introduction: Prolactinoma account for 40% of all pituitary tumors. It is the most common cause of hyperprolactinemia. Infertility, galactorrhea and hirsutism are the significant symptoms. Polycystic ovary syndrome affects the 510% of the women in reproductive age. The most common symptoms are irregular menses, hirsutism and infertility. However, prolactinoma and PCOS association is rare. A case of PCOS and prolactinoma is reported.
Case: A 21-year-old woman was admitted to internal medicine outpatient clinic for irregular menses and hirsutism for 2 years. Physical examination, revealed hirsutism (Ferrimann-Gallwey score 12 points). Her laboratory results were as follows: prolactin level 70 ng/ml (range: 1.820.3 ng/ml), testosterone 21.9 pg/ml (normal <12 pg/ml). TSH, free T3, free T4, kidney and liver function tests, estrogens, DHEAS levels were normal. Pelvic ultrasonography was correlated with polycystic ovary syndrome. Pituitary MRI showed 5×6 mm microadenoma. Carbegolide 0.25 mg(Dostinex) once a week and drosperidone/etinilestradiol(Yasminelle) daily, were started.
After 6 months of carbegoline and drosperidone/etinilestradiol treatment their prolactin and testosterone levels were normal and no adenoma was detected in pituitary MRI.
Discussion: The patient was admitted to our clinic because of irregular menses, hirsutism, pelvic US result and pituitary MRI lead to PCOS and prolactinoma association diagnosis.
In 1520% of the PCOS patients mild elevated prolactin levels can be functionally found without prolactinoma. Persistent high prolactin levels in PCOS of reproductive age women, prolactinoma must be taken into account after excluding causes such as drugs and hypothyroidism.
Conclusion: PCOS and prolactinoma association should be taken into account in PCOS cases with mild hyperprolactinemia.
30 Apr - 04 May 2011
European Society of Endocrinology