Hyperprolactinemia: still perplexing but eminently treatable
The surgeon wanted to approach the pituitary through the nose. He suspected a tumor. Why else would an acromegalic patient's growth hormone levels remain high after radiation therapy?The endocrinologist was opposed to the operation, believing that a tumor could not be present. After all, air-contrast studies had shown an empty sella."I went in anyway," recalls Jules Hardy, MD, professor and chairman, Department of Neurosurgery, University of Montreal. "And a tiny nodule popped out." Subsequently, in hyperprolactinemic patients, he discovered similar nodules: tiny prolactin-secreting adenomas, or prolactinomas."Now everyone is talking about microadenomas," Hardy told JAMA MEDICAL NEWS. "When I first tried to tell people about them, no one believed they existed."But as experience with transsphenoidal microsurgery has increased, knowledge of the small tumors' existence and of the associated hyperprolactinemic syndrome has grown apace. Now it is known that hyperprolactinemia may