Hyperprolactinemia and Pituitary Macroadenoma
Dragana Jokic, MD and Xiangbing Wang, MD, PhD
Division of Endocrinology and Metabolism,
Robert Wood Johnson Medical School
University of Medicine and Dentistry
New Brunswick, New Jersey
Corresponding Author: Xiangbing Wang, MD, PhD FACE
Division of Endocrinology, Metabolism & Nutrition
Robert Wood Johnson University Hospital-UMDNJ
MEB 384B, 1 RWJ Place, P.O. Box 19. New Brunswick, NJ 08903
Phone (732) 235-7751 Fax (732) 235-7069 E-mail:
Objective: Our purpose is report a case of primary
hypothyroidism associated with hyperprolactinemia and pituitary
macroadenoma. Background: We present
the case report, including detailed laboratory and radiological findings
in 28 year old woman. In primary hypothyroidism there is hyperplasia of
both thyrotrophs and lactotrophs as a response to TRH hypersecretion.
The hyperplasia can result in significant enlargement of the pituitary
gland and can be mistaken for a prolactin-secreting tumor.
Case: We report the case of a female
patient who presented with amenorrhea of 7-months duration and was found
by her gynecologist to have elevated prolactin. The initial MRI showed a
1.7 cm pituitary mass which was treated initially by cabergoline. Due to
the patients noncompliance and lack of follow up, the patient remained
on cabergoline for 6 months and did not do thyroid function tests.
Finally, after 6 months, a follow up MRI showed no change in size of her
pituitary mass. Also, blood tests showed profound hypothyroidism, and
after 6 month of thyroid replacement therapy, the patient was euthyroid.
A repeated MRI of the brain showed complete resolution of the pituitary
mass. Result: This case emphasizes the importance of evaluation of
thyroid function in cases of elevated prolactin and gonadal dysfunction.
Despite a lack of the typical clinical presentation of hypothyroidism,
resolution of the patientís symptoms and disappearance of her pituitary
macroadenoma confirms the diagnosis. Conclusion:
This case illustrates that primary hypothyroidism can present with
amenorrhea and pituitary mass.
Keywords ● Amenorrhea ●
Hyperprolactinemia ● Hypothyroidism ● Pituitary
macroadenoma ● Prolactin
Citation: Jokic, D. and Wang,X.:
Primary hypothyroidism associated with
hyperprolactinemia and pituitary macroadenoma. Thyroid Science,
© 2011 Thyroid Science