Skip to main content
Log in

Macroprolactinoma associated with Cushing’s disease, successfully treated with cabergoline

  • Case Report
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Drange M., Fram N., Herman-Bonert V., Melmed S. Pituitary tumour registry: a novel clinical resource. J. Clin. Endocrinol. Metab. 2000, 85: 168–174.

    CAS  PubMed  Google Scholar 

  2. 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.

    Article  CAS  Google Scholar 

  3. 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.

    CAS  PubMed  Google Scholar 

  4. 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.

    Article  CAS  PubMed  Google Scholar 

  5. 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.

    CAS  Google Scholar 

  6. 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.

    Article  Google Scholar 

  7. 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.

    Article  CAS  PubMed  Google Scholar 

  8. 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.

    Article  CAS  PubMed  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. 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.

    CAS  PubMed  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. Caufriez A., Désir D., Szyper M., Robyn C., Copinschi G. Prolactin secretion in Cushing’s disease. J. Clin. Endocrinol. Metabol. 1981, 53: 843–846.

    Article  CAS  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  Google Scholar 

  16. 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

    Article  Google Scholar 

  17. 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.

    Article  CAS  Google Scholar 

  18. 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.

    Article  CAS  Google Scholar 

  19. Miller J.W., Crapo L. The medical treatment of Cushing’s syndrome. Endocr. Rev. 1993, 14: 443–458.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guy T’sjoen.

Rights and permissions

Reprints 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

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03343983

Key-words

Navigation