Abstract
An 8 year old boy presented with left prootosis, oculomotor weakness and bilateral galactorrhoea after a 4-year history of headaches. At craniotomy a large, infiltrating pituitary tumour was partially removed. At secondary referral GE9800 scan showed infiltration of the left cavernous sinus and orbit. Serum prolactin (Prl) ranged between 200,000 and 300,000 mU/1 (normal <360 mU/1) and was unchanged on bromocriptine 30 mg/day which was poorly tolerated. Further tumour was excised at a second craniotomy. Histology showed an adenoma with frequent mitoses and positive immunostaining with Prl-antiserum in most cells. EM showed prominent rough endoplasmic reticulum but sparse neurosecretory granules and some microvilli. Immunostaining with colloidal gold Prl-antiserum demonstrated Prl within the granules Post-operatively Prl was 260,000 mU/1. Radiotherapy was given in a dose of 4500 cGy with the dopamine agonist mesulergine 10 mg daily. After one month, Prl fell to 83,500 mU/1. Mesulergine was replaced by bromocriptine 40 mg daily which, now well tolerated, induced a further fall in Prl to 40,200 mU/1 where it has remained static. 9 months post-radiotherapy he is well with resolution of proptosis and oculomotor weakness. Tumour shrinkage was thus demonstrated with radiotherapy and dopamine agonist therapy in this tumour rarely seen in childhood.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sinn, D., Grossman, A., Jones, A. et al. 55 Prolactinoma in a prepubertal child: response to Surgery, radiotherapy and dopamine agonist therapy. Pediatr Res 19, 612 (1985). https://doi.org/10.1203/00006450-198506000-00075
Issue Date:
DOI: https://doi.org/10.1203/00006450-198506000-00075