Endocrine Abstracts

The aim of said presentation was to direct attention to possibility of misdiagnosis of patients with a giant prolactinomas.

A 36 years-old man was admitted to our Centre with complaints of headaches, decline of left eye vision, absence of erection, accompanied with a decline in libido and galactorrhea. These symptoms began since August 2001. At October 2004 reduction of the vision on both eyes was revealed as well as contraction of vision fields. At the presentation the patient had excess weight, muscle weakness, body hair reduction, along the following with lab data (prolactin level was 48527 mU/l, Testosterone level – 2.1 nmol/l, DHA-S 14 mcmol/l) and data of MRI inspection (macroadenoma with endo-ante-supra-infra-laterocellaric expansion). This led us to suspect the diagnosis of giant prolactinomas, secondary hypogonadism, galactorrhea. The treatment of cabergoline (0.5 mg a week with gradual increase until dosage of 3,5 mg a week was reached) was recommended. ?t control examination at March 2005 the decline in frequency of headaches, vision disturbances, galactorrhea and also the recovery of erection was noted. The PRL level decreased to 990 mU/l. Data of MRI – reduction of the tumor size by 2,3 times was noted. During the period of the treatment the patient’s wife become pregnant.

The diagnostics of male prolactinomas is a complicated task, because clinical signs of the disease can vary broadly and thus, by their subjective character, can prevent the timely medical attention. But in presence of a primary medicament treatment the positive dynamic, recovery of reproductive function, reduction of the tumor sizes can be observed in most cases.