The results of treatment of pituitary adenomas with hyperprolactinemia (author's transl)

Abstract

1. We studied serum PRL abnormalities inpatients with various disorders of hypothalamo-hypophyseal system. When the basal serum PRL level was above 300 ng/ml, the presence of pituitary adenoma was strongly suggested. 2. Of 16 pituitary adenomas with hyperprolactinemia, 9 were associated with acromegaly (6 males, 3 females) and 7 with Forbes-Albright syndrome (amenorrhea-galactorrhea syndrome). Galactorrhea was also found in 6 of these 9 acromegalic patients, interestingly 3 of them were male cases. Amenorrhea was seen in all female cases with hyperprolactinemia except for one acromegalic case. 3. Serum PRL levels ranged from 46.2 to 508.2 ng/ml (mean: 203.2 ng/ml) in acromegalic patients and from 222.0 to 2100.0 ng/ml (mean: 1289.9 ng/ml) in patients with Forbes-Albright syndrome. Thus, the latter showed significantly higher levels of serum PRL. 4. Acromegalic patients showed more than 50% increment of serum PRL to TRH infusion, whereas, almost all patients with Forbes-Albright syndrome did less than 50%. 5. Intratumoral hemorrhage was found in 4 patients with Forbes-Albright syndrome by surgery. Two of them had episodes of pituitary apoplexy preoperatively. 6. It should be emphasized that early diagnosis and treatment is essential to normalize the dysfunction of hypothalamo-hypophyseo-gonadal axis. We consider that in patients with Forbes-Albright syndrome, visual disturbances and galactorrhea could be cured in almost all patients and ovarian dysfunction could also be normalized about more than half by transsphenoidal surgery combined with CB-154 and/or irradiation.