Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment
A 32-year-old woman presented with primary amenorrhoea, prolactin (PRL) level of 154 150 mIU/L and was diagnosed with a giant pituitary adenoma measuring maximum 6.2 cm. Cabergoline (CAB) treatment at a dose of 0.5 mg/week was prescribed to the patient. The treatment decreased the tumour size after...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2019-09-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM19-0023.xml |
| _version_ | 1819027858356436992 |
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| author | L I Astaf’eva Y G Sidneva B A Kadashev P L Kalinin G A Melnichenko S A Agadzhanian |
| author_facet | L I Astaf’eva Y G Sidneva B A Kadashev P L Kalinin G A Melnichenko S A Agadzhanian |
| author_sort | L I Astaf’eva |
| collection | DOAJ |
| description | A 32-year-old woman presented with primary amenorrhoea, prolactin (PRL) level of 154 150 mIU/L and was diagnosed with a giant pituitary adenoma measuring maximum 6.2 cm. Cabergoline (CAB) treatment at a dose of 0.5 mg/week was prescribed to the patient. The treatment decreased the tumour size after 3 months (MRI scans of the brain) and brought back to normal the level of the PRL (345 mIU/L) after 6 months of CAB treatment. After 7 months of CAB treatment, menarche was achieved, and after 12 months, the patient became pregnant. She discontinued taking CAB at 4-week gestation. The pregnancy resulted in a missed miscarriage at 6–7 weeks; an abortion was conducted by the vacuum aspiration method. The MRI scans of the brain did not show any tumour enlargement. After 18 months from the start of the treatment the patient got pregnant for the second time. At 25-week gestation an MRI scan of the brain was conducted which did not show any increase in the tumour size. At 38 weeks the patient delivered a healthy full-term girl via C-section. The patient chose not to breastfeed and resumed CAB therapy after the delivery. During the treatment, the PRL level returned to the normal range and the menstrual cycle was restored. After 3 years the patient got pregnant for the third time. The patient did not receive CAB during the pregnancies; the examination did not show any tumour enlargement. Further MRI scans did not show any tumour growth. CAB therapy was effective in normalization of the PRL level, tumour shrinkage, menarche and pregnancy-induction which led to the birth of healthy children in a woman with primary amenorrhoea and a giant prolactinoma invading the skull base bones. |
| first_indexed | 2024-12-21T05:49:09Z |
| format | Article |
| id | doaj.art-e06eebffd44546f7b656e286352591a5 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-21T05:49:09Z |
| publishDate | 2019-09-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-e06eebffd44546f7b656e286352591a52022-12-21T19:14:03ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732019-09-01111610.1530/EDM-19-0023Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatmentL I Astaf’eva0Y G Sidneva1B A Kadashev2P L Kalinin3G A Melnichenko4S A Agadzhanian5N.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russian FederationN.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russian FederationN.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russian FederationN.N. Burdenko National Medical Research Centre of Neurosurgery, Moscow, Russian FederationNational Medical Research Centre of Endocrinology, Moscow, Russian FederationDepartment of English Language for Natural Faculties, Lomonosov Moscow State University, Moscow, Russian FederationA 32-year-old woman presented with primary amenorrhoea, prolactin (PRL) level of 154 150 mIU/L and was diagnosed with a giant pituitary adenoma measuring maximum 6.2 cm. Cabergoline (CAB) treatment at a dose of 0.5 mg/week was prescribed to the patient. The treatment decreased the tumour size after 3 months (MRI scans of the brain) and brought back to normal the level of the PRL (345 mIU/L) after 6 months of CAB treatment. After 7 months of CAB treatment, menarche was achieved, and after 12 months, the patient became pregnant. She discontinued taking CAB at 4-week gestation. The pregnancy resulted in a missed miscarriage at 6–7 weeks; an abortion was conducted by the vacuum aspiration method. The MRI scans of the brain did not show any tumour enlargement. After 18 months from the start of the treatment the patient got pregnant for the second time. At 25-week gestation an MRI scan of the brain was conducted which did not show any increase in the tumour size. At 38 weeks the patient delivered a healthy full-term girl via C-section. The patient chose not to breastfeed and resumed CAB therapy after the delivery. During the treatment, the PRL level returned to the normal range and the menstrual cycle was restored. After 3 years the patient got pregnant for the third time. The patient did not receive CAB during the pregnancies; the examination did not show any tumour enlargement. Further MRI scans did not show any tumour growth. CAB therapy was effective in normalization of the PRL level, tumour shrinkage, menarche and pregnancy-induction which led to the birth of healthy children in a woman with primary amenorrhoea and a giant prolactinoma invading the skull base bones.https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM19-0023.xml |
| spellingShingle | L I Astaf’eva Y G Sidneva B A Kadashev P L Kalinin G A Melnichenko S A Agadzhanian Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment Endocrinology, Diabetes & Metabolism Case Reports |
| title | Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| title_full | Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| title_fullStr | Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| title_full_unstemmed | Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| title_short | Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| title_sort | restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment |
| url | https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM19-0023.xml |
| work_keys_str_mv | AT liastafeva restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment AT ygsidneva restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment AT bakadashev restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment AT plkalinin restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment AT gamelnichenko restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment AT saagadzhanian restorationoffertilityinawomanwithgiantprolactinomainresponsetocabergolinetreatment |