Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women

Ana Espinosa De Ycaza, Alice Y Chang, Jani R. Jensen, Zaraq Khan, Dana Erickson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective To describe 2 cases of macroprolactinomas with atypical presentation in women desiring pregnancy that illustrate important considerations in the management approach for macroprolactinomas in reproductive-aged women. Patient(s) Case 1 was a 26-year-old woman referred to our institution for possible tumor resection after pituitary apoplexy during her first pregnancy. Instead, she underwent treatment with cabergoline for a year with goals of normalization of prolactin and decrease in tumor size to < 1 cm before trying to conceive. Case 2 was an 18-year-old woman with a macroprolactinoma intolerant to dopamine agonists. She underwent stereotactic radiosurgery, with marked reduction in tumor size and normalization of prolactin levels. She conceived and delivered a healthy infant 3 years after radiosurgery. Conclusion Management of macroprolactinomas in women desiring pregnancy requires careful consideration of alternatives to surgery which could impair pituitary function and fertility and awareness of treatment goals that can minimize the risks for pituitary apoplexy and vision loss during pregnancy. It is important to increase awareness of these options prior to initiation of treatment and conception.

Original languageEnglish (US)
Pages (from-to)9-12
Number of pages4
JournalCase Reports in Women's Health
Volume8
DOIs
StatePublished - Oct 1 2015

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Prolactinoma
Pituitary Apoplexy
Pregnancy
Radiosurgery
Prolactin
Neoplasms
Dopamine Agonists
Fertility
Therapeutics

Keywords

  • Abbreviations MRI magnetic resonance imaging
  • DA dopamine agonists
  • IGF-1 Insulin-like growth factor-1

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women. / Espinosa De Ycaza, Ana; Chang, Alice Y; Jensen, Jani R.; Khan, Zaraq; Erickson, Dana.

In: Case Reports in Women's Health, Vol. 8, 01.10.2015, p. 9-12.

Research output: Contribution to journalArticle

Espinosa De Ycaza, Ana ; Chang, Alice Y ; Jensen, Jani R. ; Khan, Zaraq ; Erickson, Dana. / Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women. In: Case Reports in Women's Health. 2015 ; Vol. 8. pp. 9-12.
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AB - Objective To describe 2 cases of macroprolactinomas with atypical presentation in women desiring pregnancy that illustrate important considerations in the management approach for macroprolactinomas in reproductive-aged women. Patient(s) Case 1 was a 26-year-old woman referred to our institution for possible tumor resection after pituitary apoplexy during her first pregnancy. Instead, she underwent treatment with cabergoline for a year with goals of normalization of prolactin and decrease in tumor size to < 1 cm before trying to conceive. Case 2 was an 18-year-old woman with a macroprolactinoma intolerant to dopamine agonists. She underwent stereotactic radiosurgery, with marked reduction in tumor size and normalization of prolactin levels. She conceived and delivered a healthy infant 3 years after radiosurgery. Conclusion Management of macroprolactinomas in women desiring pregnancy requires careful consideration of alternatives to surgery which could impair pituitary function and fertility and awareness of treatment goals that can minimize the risks for pituitary apoplexy and vision loss during pregnancy. It is important to increase awareness of these options prior to initiation of treatment and conception.

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