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De Ycaza AE, Chang AY, Jensen JR, et al. Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women. Case Rep Womens Health. 2015;8:9-12doi: 10.1016/j.crwh.2015.09.001.
De Ycaza, A. E., Chang, A. Y., Jensen, J. R., Khan, Z., & Erickson, D. (2015). Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women. Case reports in women's health, 89-12. https://doi.org/10.1016/j.crwh.2015.09.001
De Ycaza, Ana Espinosa, et al. "Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women." Case reports in women's health vol. 8 (2015): 9-12. doi: https://doi.org/10.1016/j.crwh.2015.09.001
De Ycaza AE, Chang AY, Jensen JR, Khan Z, Erickson D. Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women. Case Rep Womens Health. 2015 Oct;8:9-12. doi: 10.1016/j.crwh.2015.09.001. Epub 2015 Sep 24. PMID: 27668187; PMCID: PMC5033506.
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Case Rep Womens Health. 2015 Oct;8:9-12. doi: 10.1016/j.crwh.2015.09.001. Epub 2015 Sep 24.

Approach to the management of rare clinical presentations of macroprolactinomas in reproductive-aged women.

Case reports in women's health

Ana Espinosa De Ycaza, Alice Y Chang, Jani R Jensen, Zaraq Khan, Dana Erickson

Affiliations

  1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, 200 First Street SW, Mayo Clinic, Rochester, MN, 55905, United States.
  2. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, 200 First Street SW, Mayo Clinic, Rochester, MN, 55905 United States.
  3. Division of Reproductive Endocrinology and Infertility, 200 First Street SW, Mayo Clinic, Rochester, MN, 55905, United States.

PMID: 27668187 PMCID: PMC5033506 DOI: 10.1016/j.crwh.2015.09.001

Abstract

OBJECTIVE: To describe 2 cases of macroprolactinomas with atypical presentation in women desiring pregnancy that illustrate important considerations in the management approach for macroprolactinomas in reproductive-aged women.

PATIENTS: Case 1 was a 26-year-old woman referred to our institution for possible tumor resection after pituitary apoplexy during her first pregnancy. Instead, she underwent treatment with cabergoline for a year with goals of normalization of prolactin and decrease in tumor size to <1 cm before trying to conceive. Case 2 was an 18-year-old woman with a macroprolactinoma intolerant to dopamine agonists. She underwent stereotactic radiosurgery, with marked reduction in tumor size and normalization of prolactin levels. She conceived and delivered a healthy infant 3 years after radiosurgery.

CONCLUSION: Management of macroprolactinomas in women desiring pregnancy requires careful consideration of alternatives to surgery which could impair pituitary function and fertility and awareness of treatment goals that can minimize the risks for pituitary apoplexy and vision loss during pregnancy. It is important to increase awareness of these options prior to initiation of treatment and conception.

Keywords: Pituitary apoplexy; Pregnancy; Radiosurgery; United States

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