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Spontaneous Regression Of Prolactin-producing Pituitary Adenomas

Vaughn et al., 1980Brain tumor

American Journal of Obstetrics and Gynecology 136(8): Apr 15 1980; 980-982

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Abstract

An 18-year-old woman had postpartum thyrotoxicosis, hypercalcemia, and secondary adrenocortical insufficiency. A pituitary mass with suprasellar extension was demonstrated on computed axial tomography (CT). The patient subsequently became hypothyroid and normocalcemic, and repeated CT scanning showed that the pituitary mass had undergone a spontaneous regression in size. Computed axial tomographic scanning is an important modality for the evaluation of postpartum pituitary masses and their natural history. This case suggests that some patients with postpartum hypopituitarism and a pituitary mass need not have early surgical intervention but may be closely observed and treated by hormone replacement alone.

Case Details

Personal Characteristics

Two women evaluated for amenorrhea, galactorrhea, and hyperprolactinemia

Clinical Characteristics

Radiographic changes of the sella turcica (localized erosion on trispiral tomography) suggestive of a pituitary tumor

Remission Characteristics

Spontaneous regression of apparent prolactin-secreting adenomas with a marked decrease in the quantity of galactorrhea and a reduction of serum prolactin concentrations to the normal range

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

One patient noted a marked improvement of headaches and spontaneous menses resumed in the other patient.