Abstract
Multiple pituitary hormone hypersecretions have already been described, but the co-occurrence of PRL and ACTH excess is very rare. To our knowledge, medical treatment with cabergoline only, avoiding pituitary surgery and radiotherapy in this type of tumor has never been reported before. This case report deals with a 31-yr-old man affected with a macroprolactinoma associated with a florid clinical image of Cushing’s disease. Normalization of the prolactin levels and the disappearance of clinical and biochemical features of Cushing’s disease were obtained after administration of medical treatment only.
Similar content being viewed by others
References
Drange M., Fram N., Herman-Bonert V., Melmed S. Pituitary tumour registry: a novel clinical resource. J. Clin. Endocrinol. Metab. 2000, 85: 168–174.
Li J., Stefaneanu L., Kovacs K., Horvath E., Smyth H.S. Growth hormone (GH) and prolactin (PRL) gene expression and immunoreactivity in GH- and PRL-producing human pituitary adenomas. Virchows Arch. (A) 1993, 422: 193–197.
Scheithauer B.W., Horvath E., Kovacs K., Laws E.R., Randall R.V., Ryan N. Plurihormonal pituitary adenomas. Semin. Diagn. Pathol. 1986, 3: 69–82.
Sherry S.H., Guay A.T., Lee A.K., Hedley-Whyte E.T., Federman M., Freidberg S.R., Wolf P.D. Concurrent production of adrenocorticotropin and prolactin from two distinct cell lines in a single pituitary adenoma: a detailed immunohistochemical analysis. J. Clin. Endocrinol. Metab. 1982, 55: 947–955.
Yamaji T., Ishibashi M., Teramoto A., Fukushima T. Prolactin secretion by mixed ACTH-prolactin pituitary adenoma cells in culture. Acta Endocrinol. (Copenh.) 1985, 108: 456–463.
Shulte H.M., Allolio B., Gunther R.W., Benker G., Winkelmann W., Ohnhaus E.E. Selective bilateral and simultaneous catheterization of the inferior petrosal sinus: CRF stimulates prolactin secretion from ACTH-producing microadenomas in Cushing’s disease. Clin. Endocrinol. (Oxf.) 1988, 28: 289–294.
Mahler C., Verhelst J., Klaes R., Trouillas J. Cushing’s disease and hyperprolactinemia due to a mixed ACTH- and prolactin secreting pituitary macroadenoma. Pathol. Res. Pract. 1991, 187: 598–602.
Gheri R.G., Boddi W., Ammannati F., Olivotto J., Nozzoli C., Franchi A., Bordi L., Luisi L.E, Mennonna P. Two-step developement of a pituitary adenoma: from hyperprolactinemic syndrome to Cushing’s disease. J. Endocrinol. Invest. 1997, 20: 240–244.
Barause M., Attanasio R., Dallabonzana D., Oppizzi G., Veronese S., Lasio G., Valentini L.G., Cozzi R. From macroprolactinoma to concomitant ACTH-PRL hypersecretion with Cushing’s disease. J. Endocrinol. Invest. 2000, 23: 107–111.
Rodriguez S., Alger M., Forsbach G., Contreras S.N., Canales E.S., Zarate A. Amenorrhea-galactorrhea associated with Cushing’s disease due to pituitary tumor. J. Endocrinol. Invest 1981, 4: 37–40.
Jurney T.H., De Ruyter H., Vigersky R.A. Cushing’s disease presenting with amenorrhea with hyperprolactinemia: report of two cases. Clin. Endocrinol. (Oxf.) 1991, 14: 539–545.
Kontogeheorgos G., Kovacs K., Horvath E., Scheithauer B.W. Multiple adenomas of the human pituitary: a retrospective autopsy study with clinical implications. J. Neurosurg. 1991, 4: 243–247.
Caufriez A., Désir D., Szyper M., Robyn C., Copinschi G. Prolactin secretion in Cushing’s disease. J. Clin. Endocrinol. Metabol. 1981, 53: 843–846.
Raffel C., Boggan J.E., Eng L.F., Davis R.L., Wilson C.B. Pituitary adenomas in Cushing’s disease: do they arise from the intermediate lobe? Surg. Neurol. 1988, 30: 125–130.
Lamberts S.W.J., de Lange S., Stefanko S.Z. Adrenocorticotropin-secreting pituitary adenomas originate from the anterior or the intermediate lobe in Cushing’s disease: differences in the regulation of hormone secretion. J. Clin. Endocrinol. Metabol. 1982, 54: 286–291.
Orth D., Holscher M., Wilson M., Nicholson W., Plue R., Mount C. Equine Cushing’s disease: plasma immunoreactive proopiolipomelanocortin peptide and cortisol levels basally and in response to diagnostic tests. Endocrinology 1982, 11: 1430–1441
Invitti C., Pecori Giraldi F., Tagliaferri A., Scacchi M., Dubini A., Cavagnini F. Enhanced prolactin responsiveness to galanin in patients with Cushing’s disease. Clin. Endocrinol. (Oxf.) 1993, 39: 213–216.
Adachi M., Takayanagi R., Yanase T., Sakai Y., Ikuyuma S. Cyclical Cushing’s disease in long-term remission with a daily low dose of bromocriptine. Int. Med. 1996, 35: 207–211.
Miller J.W., Crapo L. The medical treatment of Cushing’s syndrome. Endocr. Rev. 1993, 14: 443–458.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
T’sjoen, G., Defeyter, I., Van De Saffele, J. et al. Macroprolactinoma associated with Cushing’s disease, successfully treated with cabergoline. J Endocrinol Invest 25, 172–175 (2002). https://doi.org/10.1007/BF03343983
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03343983