Munazzah Rafique, Solaiman Alobaid and Dania Aljaroudi
Giant prolactinomas are rare pituitary gland tumours found in paediatric and adolescent patients. The pituitary gland controls metabolism, growth, sexual maturation, reproduction, blood pressure, and other vital physical functions. A 15-year-old girl presented with headache, blurred vision, primary amenorrhea and significantly high prolactin (PRL) levels with baseline level of 344,727 µg/L. Turner syndrome, Müllerian agenesis, hypothalamic amenorrhea, and primary ovarian insufficiency were excluded by laboratory and radiologic tests. Initial brain computed tomography revealed a giant pituitary adenoma and ultrasonography revealed an infantile uterus. Pituitary gland resection confirmed prolactinoma. With medical treatment, menstruation was restored uterine and ovarian parameters were improved with increased endometrial thickness and ovaries showing follicles. However, symptom recurrence and resistance to treatment warranted surgical and radiological interventions. This case report calls attention to the role of prolactin in uterine development and the need to include prolactin level in key investigations in patients with primary amenorrhea.
Published Date: 2019-04-24; Received Date: 2019-02-21