Endocrine Abstracts

Introduction: Prolactinomas are the most common hormone secreting pituitary adenomas. Also hyperprolactinemia is the cause of a third of all cases of female infertility, yet with adequate management, most patients are able to achieve pregnancy. The purpose of this paper is to reporte the effectiveness of medical treatment in restoring fertility, while managing prolactinoma.And also to illustrate the follow-up of prolactinoma during pragnancy.

Cases: The first patient was 32 years old, had galactorrhea associated with amenorrhea about 3 years ago. Subsequent investigations revealed hyperprolactinemia. Pituitary MRI confirmed a sellar lesion (<1 cm). the therapeutic decision was to treat with Cabergoline.The second patient was 42 years old, had a macroprolactinoma revealed by cycle disorders installed 17 years ago, complicated 4 years later of spontaneous galactorrhea. The investigations revealed an hyperprolactinemia with a sellar lesion measuring 11×11 mm, because of financial problems, the patient could not receive medication and got complications such us, visual disturbances and headache, with increasing of the size of the tumor (12 mm×16 mm). She was treated immediately with Cabergoline.The third one was a 41 years old patient, she had a macroprolactinoma revealed by secondary amenorrhea and galactorrhea with bilateral visual acuity decrease. She was treated with bromocriptine. The three women did not follow the instructions of making contraceptifs précautions and became pregnant after few months of treatment. The management of each case was depending on the tumor volume.

Conclusion: Treatment with dopamine agonists usually restores ovulation and fertility. The treatment with Cabergoline is generally being preferred to bromocriptine because of its higher therapeutic efficacy/adverse effects ratio.