J Korean Endocr Soc.  2009 Mar;24(1):42-46. 10.3803/jkes.2009.24.1.42.

Normal Repetitive Pregnancies and Tumor Regression Induced by Low-Dose Bromocriptine in a Patient with Macroprolactinoma

• Choi HJ
• Park JY
• Choi WS
• Song JG
• Kim HY
• Seo JA
• Kim SG
• Kim NH
• Choi KM
• Baik SH
• Choi DS

• KMID: 1468495
• DOI: http://doi.org/10.3803/jkes.2009.24.1.42

Abstract

Prolactin-secreting adenomas are the most common pituitary tumors. Menstrual disturbances and infertility are the main complaints in women with prolactinoma. Dopaminergic agonists such as bromocriptine are well-established treatments for prolactinoma when pregnancy is desired. Pregnancy-related outcomes in macroprolactinoma are worse than those in microprolactinoma. In addition, symptomatic tumor expansion during pregnancy occurs in 30% of women with macroprolactinoma. Therefore, when women with macroprolactinoma are planning a pregnancy, serum prolactin level should be normalized and the tumor volume significantly reduced. On the other hand, a spontaneous regression of macroprolactinoma can occur after pregnancy. We report a case of macroprolactinoma showing significant tumor regression during repeated pregnancies and low dose bromocriptine treatment, with a literature review.

Keyword

Bromocriptine; macroprolactinoma; pregnancy

MeSH Terms

Adenoma
Bromocriptine
Dopamine Agonists
Female
Hand
Humans
Infertility
Pituitary Neoplasms
Pregnancy
Prolactin
Prolactinoma
Tumor Burden
Bromocriptine
Dopamine Agonists
Prolactin

Figure

• 

  Fig. 1 Sellar MRI. The diameter of the tumor is 2.3 × 1.7 cm with suprasellar extension to compress optic chiasm. It is mainly cystic with high signal intensity on T2 weighted image (A. sagittal view. B. coronal view).

• 

  Fig. 2 Sellar MRI. No evidence of residual pituitary adenoma. Pituitary stalk deviated to right and a small T1 hyperintense nodule at the end of stalk which is thought to be abnormal developed neurohypophysis due to adenoma are showed (A. sagittal view. B. coronal view).

• 

  Fig. 3 Change in serum prolactin level during treatment and pregnancy.

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