scholarly journals Ectopic Prolactin Secretion From a Uterine Leiomyoma

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Saachi Sachdev ◽  
Maria Carolina Reyes ◽  
Peter J Snyder
Keyword(s):  
Prolactin Level ◽  
Uterine Leiomyoma ◽  
Prolactin Secretion ◽  
Sellar Mass ◽  
Hormone Production ◽  
Ectopic Production ◽  
First Time

Abstract Ectopic hormone production is well recognized, but ectopic production of prolactin has been reported infrequently. We report here the case of a 47-year-old woman who had hyperprolactinemia (213-224 ng/mL) causing galactorrhea and hypogonadism. Cabergoline treatment, 1.0 mg twice a week, did not lower the prolactin level at all, but excision of a large uterine leiomyoma corrected the hyperprolactinemia and the hypogonadism. The excised leiomyoma tissue exhibited immunostaining for prolactin, confirming by this method for the first time that a uterine leiomyoma was the cause of hyperprolactinemia. This case illustrates the need to consider an ectopic source of prolactin in a patient who has hyperprolactinemia that is not associated with a large sellar mass and is completely resistant to cabergoline.

Danazol and prolactin status in patients with endometriosis

1984 ◽  
Vol 107 (4) ◽  
pp. 445-449 ◽  
Author(s):  
A. M. Wallace ◽  
D. A. R. Lees ◽  
A. D. G. Roberts ◽  
C. E. Gray ◽  
E. H. McLaren ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Prolactin Secretion ◽  
Normal Serum ◽  
Serum Prolactin ◽  
Serum Prolactin Level ◽  
Significant Drop ◽  
Increased Sensitivity ◽  
Danazol Therapy

Abstract. A group of 55 women with endometriosis was studied before and during danazol therapy. An unexpectedly high proportion (36%) had a raised serum prolactin level before treatment which was reduced after 50 days of danazol (before treatment 783 ± 333 mU/l; on danazol 243 ± 113 mU/l, P < 0.001). In contrast patients with normal serum prolactin levels showed no significant drop on danazol therapy. In all patients serum oestradiol was significantly reduced during treatment (before treatment 449 ± 188 pmol/l; on danazol 207 ± 117 pmol/l, P < 0.001). In one patient with hyperprolactinaemia danazol reduced both basal and stimulated prolactin levels, whereas in 5 women with normal prolactin levels we could detect no gross alteration in metoclopramide or TRH stimulated prolactin levels associated with danazol therapy. The possibility that normalisation of raised prolactin levels may be secondary to reduced oestrogens and that patients with endometriosis have an increased sensitivity to oestrogen-induced prolactin secretion is discussed.

Some Aspects of Pituitary Function after Neuroadenolysis in Patients with Metastatic Cancer

1981 ◽  
Vol 67 (4) ◽  
pp. 355-359 ◽  
Author(s):  
Nagesh Deshpande ◽  
Guido Moricca ◽  
Franco Saullo ◽  
Luciano Di Martino ◽  
Giok Kwa
Keyword(s):  
Metastatic Cancer ◽  
Thyroid Stimulating Hormone ◽  
Prolactin Secretion ◽  
Pituitary Function ◽  
Releasing Hormone ◽  
Cancer Metastases ◽  
Normal Ranges ◽  
First Time ◽  
Stimulating Hormone

The effects of neuroadenolysis on plasma titres of β-endorphin, β-lipotropin, ACTH, TSH and prolactin have been investigated in five patients with metastatic cancer who responded to the treatment and have been in remission for more than four years and in five others who were undergoing the treatment for the first time for pain due to cancer metastases. β-endorphin, β-lipotropin and ACTH titres were within the normal ranges of values in both categories of patients but post-neuroadenolysis titres of these peptides were higher than those before the treatment. The ability to secrete TSH and prolactin and to respond to thyroid stimulating hormone releasing hormone (TRH) remains intact following the treatment. However, whereas basal TSH titres and response to TRH was lower in the majority of patients, no such effect was observed on prolactin secretion. Plasma titres of prolactin and TSH were below the sensitivity of the method in the five patients who are in remission for more than four years. These preliminary findings suggest that neuroadenolysis probably affects some mechanism(s) associated with the control of β-endorphin, β-lipotropin and ACTH synthesis.

Effect of short-term bromocriptine treatment on amniotic fluid prolactin concentration in the first half of pregnancy

1981 ◽  
Vol 97 (4) ◽  
pp. 559-561 ◽  
Author(s):  
P. Lehtovirta ◽  
T. Ranta
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Dopamine Receptors ◽  
Prolactin Level ◽  
Prolactin Secretion ◽  
Maternal Serum ◽  
Serum Prolactin ◽  
Fluid Level ◽  
Serum Prolactin Level ◽  
Short Term

Abstract. The effect of short-term bromocriptine treatment on amniotic fluid and maternal prolactin concentrations was studied in 9 pregnant women in the first half of pregnancy. Bromocriptine suppressed the maternal serum prolactin level, but had no effect on the amniotic fluid level. Since both foetal and maternal prolactin secretion are suppressed by bromocriptine our results suggest that amniotic fluid prolactin is produced by extrapituitary tissues, which do not contain dopamine receptors.

PARAENDOCRINE BEHAVIOUR OF HUMAN BREAST CARCINOMA: IN VITRO TRANSFORMATION OF STEROIDS TO PHYSIOLOGICALLY ACTIVE HORMONES

1968 ◽  
Vol 41 (1) ◽  
pp. 41-52 ◽  
Author(s):  
J. B. ADAMS ◽  
M. S. F. WONG
Keyword(s):  
Breast Carcinoma ◽  
Soluble Fraction ◽  
Human Breast Carcinoma ◽  
Human Breast ◽  
Significant Elevation ◽  
Hormone Production ◽  
Carcinoma Tissue ◽  
Steroid Sulphatase ◽  
First Time

SUMMARY Conversion in vitro of [4-14C]dehydroepiandrosterone and [4-14C]pregnenolone to Δ4-3-ketosteroids has demonstrated the occurrence of an isomerasedehydrogenase system in human breast carcinoma tissue. Aromatisation of [4-14C]testosterone to oestriol, via 16α-hydroxytestosterone, also occurred, thus demonstrating for the first time a paraendocrine activity associated with steroid hormone production. A major metabolite of dehydroepiandrosterone was identified as androst-5-ene-3β, 16α, 17β-triol which may be an intermediate in the 'direct' pathway to oestriol. Steroid sulphatase activity was detected in homogenates of breast carcinoma tissue. This finding, and the previously demonstrated occurrence of steroid sulphokinases in the soluble fraction, suggest that sulphated forms of the steroid may act as intermediates in some of the transformations described. These observations can possibly explain previous unaccountable reports on the metabolism of steroids administered to oophorectomized and adrenalectomized patients with breast carcinoma. The formation of oestriol and androst-5-ene-3β,16α,17β-triol by the carcinoma tissue may offer an explanation for the significant elevation of oestriol and the lowered dehydroepiandrosterone concentrations in the urine of postmenopausal women with breast cancer (Marmorston, 1966).

Ectopic Hormone Production by Tumours

1980 ◽  
Vol 25 (2) ◽  
pp. 142-145 ◽  
Author(s):  
P. D. Bewsher
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Hormone Production ◽  
Ectopic Production ◽  
Endocrine Features

The ectopic production of hormones by tumours is important to appreciate as relevant endocrine features may antedate the appearance of other evidence of the tumour. This possibility should be borne in mind particularly when considering Cushing's syndrome, excessive ADH production or hypercalcaemia and could result in many instances in a quite different approach to further investigation and management. Carcinoma of lung is the commonest underlying neoplasm in several such situations but there are some, such as the hypoglycaemic syndromes, in which the tumour may even be benign.

EFFECTS OF MEDIAL HYPOTHALAMIC DEAFFERENTATION ON PROLACTIN SECRETION IN PSEUDOPREGNANT RATS

1978 ◽  
Vol 89 (3) ◽  
pp. 425-431 ◽  
Author(s):  
H. Kato ◽  
M. E. Velasco ◽  
I. Rothchild
Keyword(s):  
Prolactin Level ◽  
Preoptic Area ◽  
Prolactin Secretion ◽  
Anterior Hypothalamus ◽  
Corpora Lutea ◽  
Sham Operation ◽  
Posterior Half ◽  
Night Time ◽  
Hypothalamic Deafferentation

ABSTRACT Frontal hypothalamic deafferentation (FHD), which disconnects the anterior hypothalamus from the preoptic area, stops the twice daily surges of prolactin secretion of pregnancy or pseudopregnancy in the rat, and causes rapid luteolysis. Medial hypothalamic deafferentation (MHD), which separates the anterior from the posterior half of the hypothalamus, does not interrupt pregnancy and causes a significant increase in the size of the corpora lutea. To see whether MHD induces an increase in the basal level of prolactin secretion and/or a change in the pattern of prolactin surges, pseudopregnant rats were subjected to MHD or a sham operation on day 3 (day 1 = day of oestrus) and their bloods assayed for prolactin on either day 5 or days 7–8. MHD caused a specific disappearance of the day-time prolactin surge and a diminution in the height of the night-time surge, but no change from the controls in the basal prolactin level. In spite of what thus appears to be a lesser secretion of prolactin than in the controls, the corpora lutea of the MHD rats were larger, and progesterone was secreted at a higher rate and for a longer time, than in the controls. The relation of these findings to the existence of a "surge centre" in the hypothalamus was discussed.

EFFECT OF ANDROGENISATION ON ADENOHYPOPHYSIAL PROLACTIN CONTENT IN RATS

1967 ◽  
Vol 54 (4) ◽  
pp. 663-667 ◽  
Author(s):  
M. Kurcz ◽  
K. Kovács ◽  
T. Tiboldi ◽  
A. Orosz
Keyword(s):  
Mammary Gland ◽  
Postnatal Period ◽  
Prolactin Secretion ◽  
Female Rats ◽  
Early Postnatal Period ◽  
Male Rats ◽  
Hormone Production ◽  
Prolactin Content

ABSTRACT The adenohypophyses of androgenised female rats contain significantly less prolactin than control animals. Testosterone phenylpropionate administered in the early postnatal period does not markedly change the adenohypophysial prolactin content of male rats. Since examination of the mammary gland provide no evidence of increased prolactin secretion, the decrease in the adenohypophysial prolactin content of androgenised female rats must be explained by reduced hormone production. It is suggested that androgenisation in female rats influences prolactin production by an action on the hypothalamus.

scholarly journals Cerebrospinal Fluid Leak After Medical Management of Prolactinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A576-A576
Author(s):  
Amanda Pechman ◽  
Anjali Manavalan ◽  
Preeti Kishore
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Management ◽  
Prolactin Level ◽  
Sphenoid Sinus ◽  
Fluid Collection ◽  
Sella Turcica ◽  
Csf Leak ◽  
Tumor Shrinkage ◽  
Sellar Mass ◽  
Lumbar Drain

Abstract Introduction: Dopaminergic agonists such as cabergoline are commonly used to treat prolactinomas, and often lead to significant adenoma shrinkage. Rarely, macroprolactinomas may invade the sphenoid sinus and pose a therapeutic challenge, as treatment with dopamine agonists and subsequent tumor shrinkage can lead to a cerebrospinal fluid (CSF) leak. Clinical Case: A 32-year-old female with no prior medical history presented to the emergency room of an outside hospital for headaches and visual changes. MRI demonstrated a 4.3 x 4.0 x 3.0 cm sellar mass with extension into the right cavernous sinus and sphenoid sinus, and prolactin was elevated to 1,859 ng/ml (3.4 - 21.4). Cabergoline was initiated at a dose of 0.25 mg twice a week with a decrease in her prolactin to 646 ng/ml one month later. Six months after initiation of therapy she transferred her care to our institution and presented for a routine endocrinology visit. She complained of rhinorrhea worse when upright that had begun two weeks prior to this encounter. Urgent MRI of the sella revealed an interval decrease in the size of the sellar mass to 2.1 x 2.7 x 1.5 cm and a fluid collection extending from the sella turcica to the left sphenoid sinus consistent with a CSF leak, and labs showed a prolactin level of 169 ng/ml. Cabergoline was discontinued and the patient was admitted to the hospital for treatment with antibiotics and acetazolamide. She underwent lumbar drain placement while awaiting definitive surgical management, which was delayed due to the COVID-19 pandemic. While off cabergoline, the sellar mass increased in size and her prolactin rose to 1,449 ng/ml, with no effect on the optic chiasm and visual fields. Three months later, she underwent transsphenoidal debulking of the pituitary mass with repair of the sellar floor and removal of lumbar drain. Her postoperative course was uncomplicated and she resumed cabergoline 0.25 mg twice weekly. A prolactin measured two weeks postoperatively was 337 ng/ml. Tumor histopathology revealed a 1.3 x 0.4 x 0.3 cm pituitary adenoma. Immunohistochemistry stained positive for chromogranin A, synaptophysin, and prolactin only. An MRI of the sella and prolactin level will be repeated at her next endocrinology visit. Conclusions: CSF leak is a rare but serious complication from tumor shrinkage after medical management of large invasive prolactinomas, and patients with such tumors should be monitored closely for its development. CSF leaks can increase a patient’s risk for meningitis and subsequent morbidity and mortality. The management of patients with large prolactinomas with local invasion should involve a multidisciplinary approach for decision making, extensive patient education, and close follow up in order to identify and treat a CSF leak should it develop.

scholarly journals Ovulation Induction in Patients with Polycystic Ovarian Syndrome (PCOS) & Hyperprolactinemia (HPRL): Efficacy of Letrozole (LE) Combined with Cabergoline (CE) in Comparison to (LE) Alone

2021 ◽  
Vol 6 (5) ◽  
Keyword(s):  
Prolactin Level ◽  
Cardiac Activity ◽  
Prolactin Secretion ◽  
Clinical Pregnancy ◽  
Ovulation Rate ◽  
Serum Prolactin ◽  
P Value ◽  
Dopamine Receptor Agonist ◽  
Fetal Cardiac Activity

Objectives: (PCOS) is the most common cause of anovulatory infertility, with majority of patients having mild (HPRL). (CE), a dopamine receptor agonist, inhibits prolactin secretion, leading to better ovulatory response. (LE), an aromatase inhibitor, without adverse effects on endometrium & induces fewer mature follicles with less risk of OHSS. Our aim was to investigate effects of combined (LE) & (CE) in comparison to (LE) alone on ovulation & clinical pregnancy rates in (PCOS) patients with (HPRL). Patients & Methods: 180 women with (PCOS) and of 22-38 years old, were enrolled in a hospital based clinical trial. Patients randomly allocated into 2 groups, (A&B). All with a serum prolactin > 32 ng/ml. Patients in (A): (92) were given (LE), 5mg for 5days: (3 – 7 of the cycle)/3 cycles and (CE), 0.5mg weekly for 12 weeks. Those in (B): (88) received only (LE), same dose & duration as in (A). All patients were matched for their age and BMI. Exclusion criteria: other causes of (HPRL). Outcome measure: ovulation rate & detection of both chemical & clinical pregnancies by βhCG and ultrasound of fetal cardiac activity, 2-4 weeks after missed period. Follow-up for 6 months. Data analysis by using SPSS version for windows, P-value significant if (< 0.05). Results: 3 patients from (A) & 5 from (B) had drug side effects and were excluded. None of patients were lost during the follow-up period. In (A), difference between mean serum prolactin level before & after treatment was statistically significant (P<0.001): 48.3±4.2ng/ml and 8.1±5.2ng/ml, respectively. No significant decrease of prolactin level in (B) (P >0.05). After treatment, BMI in (A) 24.1± 3.2, & 24.2 ± 3.6 in (B) (P=0.567). (56.2%) of women in (A) became regularly menstruating but only (30.1%) in (B) (P< 0.05). Ovulation rate was higher in (A) (50.6%) in comparison to (B) (26.5%), (P<0.05). Clinical pregnancy rate in (A) (41.6%) and (21.6%) in (B) (P<0.05). Neither twin pregnancy, nor OHSS were recorded in both groups. Conclusions: The combination of (LE) & (CE) is superior to (LE) alone in management of anovulatory patients with (PCOS) and should be used as the first-line treatment for them.

scholarly journals Hyperprolactinemia in Acromegaly is Related to Prolactin Secretion by Somatolactotroph Tumours

2020 ◽  
Vol 52 (09) ◽  
pp. 647-653
Author(s):  
Delphine Van Laethem ◽  
Alex Michotte ◽  
Wilfried Cools ◽  
Brigitte Velkeniers ◽  
David Unuane ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Prolactin Level ◽  
Patient Characteristics ◽  
Tumour Volume ◽  
Prolactin Secretion ◽  
University Hospital ◽  
Serum Prolactin ◽  
Ki 67 ◽  
Adenoma Tissue ◽  
The University

AbstractThe aim of this study is to assess differences in patient characteristics, tumour characteristics and hormone levels between acromegalic patients with and without hyperprolactinemia. 44 patients of the University Hospital of Brussels, Belgium with acromegaly who were diagnosed between January 2007 and July 2018 were included in this study. Nineteen patients were classified in the hyperprolactinemia group and 25 patients were classified in the normoprolactinemia group. No significant differences between acromegalic patients with and without hyperprolactinemia were found in age at diagnosis, gender, presence of hyperprolactinemia symptoms, insulin-like growth factor 1, growth hormone and testosterone levels, tumour volume, tumour invasiveness, immunohistochemistry of growth hormone and prolactin, Ki-67 index and mitotic index. However, for a cut-off of 10% of prolactin-positive cells, there was a trend towards a higher percentage of prolactin-positive tumours in hyperprolactinemia patients (p=0.054) and higher mean prolactin level in case of positive prolactin immunostaining (p=0.007)). In our study there were no differences in characteristics between acromegaly patients with hyper- and normoprolactinemia. An association between the serum prolactin level and the positivity of prolactin immunohistochemistry of the adenoma tissue was found. The absence of a difference in tumour volume between patients with hyper- and normoprolactinemia suggests that the hyperprolactinemia is likely to be caused by the co-secretion of growth hormone and prolactin by the tumour. Finally, for the first time, the cut-off of 10% of prolactin cells was validated for the diagnosis of somatolactotroph tumours in acromegaly.

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