Case ReportGiant, Solid, Invasive Prolactinoma in a Prepubescent Boy With Gynecomastia
Introduction
Pituitary adenomas account for approximately 2.7% of all supratentorial tumors in childhood, with an estimated annual incidence of 0.1/million [1], [2]. Prolactinomas most commonly occur in women in the age group of 20-50 years [2]. There is sufficient evidence that prolactinomas are more aggressive and proliferative in males than in females, and are also more aggressive and proliferative in the pediatric age group [2], [3], [4]. Their presentation and optimal treatment differ from those of adults [3]. Only a few series of prolactinoma in childhood, treated either surgically or medically with dopaminergic drugs, have been reported [3], [5], [6].
Section snippets
Case Report
A 7-year-old boy presented with painless progressive vision loss, insidious in onset, and bitemporal headache of 1.5 year duration. On general examination, he exhibited bilateral gynecomastia. His optic discs were pale, and he had a visual acuity of 6/18 in the right eye and 6/36 in the left eye according to Snellen's chart examination, with a temporal field cut in the left eye. Other central nervous system findings were unremarkable.
A magnetic resonance imaging scan revealed a sellar tumor of
Discussion
Prolactin microadenomas were previously reported in boys [3]. Their most common presenting signs are primary amenorrhea in females, and gynecomastia and hypogonadism in males [7]. Prolactinomas in children are frequently associated with delayed puberty, because high prolactin levels affect hypothalamic-gonadotropic activity.
In a series of 42 patients with pediatric pituitary adenomas, Pandey et al. reported on 20 (47.6%) prolactinomas [1]. Kunwar and Wilson reported on five cases of
References (11)
- et al.
Pediatric pituitary adenoma: A series of 42 patients
J Clin Neurosci
(2005) - et al.
Cystic giant prolactinoma in childhood
J Clin Neurosci
(2008) Clinical management of prolactinomas
Baillieres Best Pract Res Clin Endocrinol Metab
(1999)- et al.
Pituitary adenomas in childhood
Indian J Pediatr
(2005) - et al.
Pituitary adenomas with onset during puberty. Features and treatment
J Neurosurg
(1983)