Abstract:
OBJECTIVE:To characterise distinctive clinical features of giant prolactinomas in women. DESIGN:A multicentre, retrospective case series and literature review. METHODS:We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg/l and identified 19 similar cases from the literature; a gender-based comparison of the frequency and age distribution was obtained from a literature review. RESULTS:The initial PubMed search using the term 'giant prolactinomas' identified 125 patients (13 women) responding to the inclusion criteria. The female:male ratio was 1:9. Another six female patients were found by extending the literature search, while our own series added 15 patients. The median age at diagnosis was 44 years in women compared with 35 years in men (P<0.05). All cases diagnosed before the age of 15 years were boys. In women (n=34), we observed a minor peak incidence during the third decade of life and a major peak during the fifth decade. Amenorrhoea was a constant feature with seven cases of primary amenorrhoea. In eight women with onset of secondary amenorrhoea before the age of 40 years, the diagnosis was made 2-31 years later (median 9 years) and in all but one because of tumour pressure symptoms. The prolactin levels were above 10,000 μg/l in 15/34 and misdiagnosis due to 'hook effect' occurred in two of them. Eighteen patients were treated with cabergoline; standard doses (<2.0 mg/week) were able to normalise prolactin in only 4/18 patients, and 7/18 patients were resistant to weekly doses ranging from 3.0 to 7.0 mg. CONCLUSION:Giant prolactinomas are rare in women, often resistant to dopamine agonists and seem to be distributed in two age groups, with a larger late-onset peak.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
Delgrange E,Raverot G,Bex M,Burman P,Decoudier B,Devuyst F,Feldt-Rasmussen U,Andersen M,Maiter Ddoi
10.1530/EJE-13-0503subject
Has Abstractpub_date
2013-11-22 00:00:00pages
31-8issue
1eissn
0804-4643issn
1479-683Xpii
EJE-13-0503journal_volume
170pub_type
杂志文章,多中心研究,评审abstract:DESIGN:While androgens and estrogens control glucocorticoid secretion in animal models, how the sex-steroid milieu determines cortisol secretion in humans is less clear. To address this issue, cortisol was measured in archival sera obtained at 10-min intervals for 5 h in 42 healthy men administered double placebo, plac...
journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
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更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Hyperthyroidism in rats produces organ hypertrophy and increases in circulating IGF-I and IGF-binding protein (IGFBP)-3. Chronic treatment with thyroxine (T(4)) during pregnancy advances parturition, blocks lactation and changes several hormone receptors in mammary gland and liver. Since IGFs are implicated i...
journal_title:European journal of endocrinology
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journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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journal_title:European journal of endocrinology
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更新日期:2005-02-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
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更新日期:2009-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-06-01 00:00:00
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更新日期:2014-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:1999-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
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更新日期:2008-06-01 00:00:00
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更新日期:2014-02-01 00:00:00
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更新日期:2015-12-01 00:00:00
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更新日期:2009-05-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2007-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-07-01 00:00:00
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更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2020-04-01 00:00:00
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更新日期:2006-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2002-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00