Pituitary apoplexy of a giant prolactinoma during pregnancy
| Autor: | Safa Khaldi, Molka Chaieb, Ghada Saad, T. Ach, Koussay Ach, Maha Kacem, Yosra Hasni, Hamza Elfekih, Asma Ben Abdelkrim, Amel Maaroufi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Cabergoline Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine Endocrinology Fatal Outcome Pituitary adenoma Pregnancy medicine Humans Pituitary Neoplasms Prolactinoma 030219 obstetrics & reproductive medicine Obstetrics business.industry Obstetrics and Gynecology Pituitary apoplexy Cytoreduction Surgical Procedures medicine.disease Magnetic Resonance Imaging Bromocriptine Prolactin Infertility Pregnancy Twin Gestation Premature Birth Female business Pituitary Apoplexy Pregnancy Complications Neoplastic medicine.drug |
| Zdroj: | Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 37(9) |
| ISSN: | 1473-0766 |
| Popis: | Aims and methods Prolactinomas are a common cause of sexual dysfunction and infertility. We aimed, through this case report, to illustrate the difficulties of management of women with giant prolactinoma, especially in cases of desire of pregnancy. Results A 30-year-old woman was referred to our department for secondary amenorrhea. Investigations showed a prolactin level of 5168 ng/mL and giant pituitary adenoma of 4 cm in diameter. Cytoreductive surgery was performed after failure to normalize prolactin levels during three years with medical treatment by cabergoline. After seven months, menstrual cycles have resumed, and after 13 months, the patient became pregnant. At 22nd week of gestation, she was admitted in our hospital for pituitary apoplexy. Medical treatment with bromocriptine was chosen. The vaginal premature delivery at 28 weeks gave birth to twins weighing 1 Kg each who died on the 7th day of life. Conclusion This is a relevant clinical case that illustrates the efficacy of cytoreductive surgery in case of insufficient response to dopamine agonists to restore gonadal function. The possibility of a pregnancy should be considered in these patients since it can be associated with high maternal and fetal risks. |
| Databáze: | OpenAIRE |
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