OBJECTIVE: This study is designed to demonstrate the factors influencing on the the postoperative remission or recurrence after transsphenoidal approach(TSA) for treatment of the prolactinomas. METHODS:This study included 18 patients who underwent TSA. Pre- and post-operative magnetic resonance(MR) image, and serum prolactin levels were checked. Classification(Grade I-V, Stage 0-E) of the tumor were performed based on the preoperative MR image and intraoperative surgical finidngs. "Remission" was defined when normal serum prolactin level without amenorrhea, galactorrhea was noticed. "Recurrence" was defined when postoperative prolactin level was above 20ng/ml and amennorrhea, galactorrhea were presented. RESULTS: Patients were grade I in eight, grade II in six, grade III in three, and grade IV in one. Postoperative results showed remission in 13 and recurrence in five. Depending on preoperative serum prolactin levels, remission was achieved in 100% of patients under 100ng/ml, 83% of patients in 100-200ng/ml, and 50% of patients above 200ng/ml. Remission was noticed in 75.0% of grade I, 83.3% of grade II, 66.6% of grade III, and 0% of grade IV. Also, remission was presented in 80.0% of stage 0, 66.7% of stage A, 0% of Stage B. CONCLUSION: After TSA, remission could be achieved in patients with low preoperative serum prolactin level, small sized tumor, and less invasive tumor into the sellar floor. It is suggested that preoperative serum prolactin level, tumor size, and invasiveness of the tumor into the sellar floor are of value in prediction of the remission after TSA in patients with prolactinoma.
Amenorrhea ; Female ; Galactorrhea ; Humans ; Pregnancy ; Prolactin ; Prolactinoma* ; Recurrence

Hyperprolactinemia is a frequent, serious adverse effect of antipsychotics. Ziprasidone seems to be less frequently associated with hyperprolactinemia than other antipsychotics. We report a case of 25-year-old woman who developed amenorrhea, galactorrhea, and hyperprolactinemia while taking ziprasidone, which resolved with the addition of aripiprazole. To our best knowledge, this is the first report that adjunctive aripiprazole attenuated ziprasidoneinduced hyperprolactinemia.
Adult ; Amenorrhea ; Antipsychotic Agents ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia ; Piperazines ; Pregnancy ; Quinolones ; Thiazoles ; Aripiprazole

The mixed gangliocytoma-pituitary adenoma is a very rare intracranial neoplasm, and it is frequently associated with endocrine symptoms; acromegaly, Cushing's disease, galactorrhea and amenorrhea. Morphologically it shows a mixture of gangliocytoma and pituitary adenoma in various proportions. In the area of gangliocytoma, there is no neoplastic glial component. The portion of pituitary adenoma consists mainly of chromophobe cells. There are three hypotheses in its histogenesis. We report a case of a 41 year-old lady presented with acromegaly and amenorrhea existing for 3 years. On magnetic resonance image, there is a dumbell-shaped mass in the sellar region. Histologically it showed typical features of mixed gangliocytoma-pituitary adenoma. This case is presented in the view of its rarity and interesting possible histogeneses.
Acromegaly ; Adenoma* ; Adult ; Amenorrhea ; Brain ; Brain Neoplasms ; Female ; Galactorrhea ; Ganglioneuroma ; Humans ; Pituitary Neoplasms ; Pregnancy

3 cases of pituitary adenomas, two hormone-secreting adenomas, and one non-secreting chromophobe adenoma, were treated surgically by the sublabial transsphenoidal approach with use of surgical microscope and radiofluroscopic image intensification at the Dept. of Neurosurgery, Yonsei University Medical College. The 2 cases of hormone secreting adenomas were an eosinophilic microadenoma manifestating gigantism and a prolaction secreting adenoma with amenorrhea and galactorrhea. The simplicity of this technique, criteria for the treatment of the hormone secreting and non-secreting adenomas and their biologic behaviors were described and discussed with review of literatures.
Adenoma ; Adenoma, Chromophobe ; Amenorrhea ; Eosinophils ; Female ; Galactorrhea ; Gigantism ; Neurosurgery ; Pituitary Neoplasms ; Pregnancy

3 cases of pituitary adenomas, two hormone-secreting adenomas, and one non-secreting chromophobe adenoma, were treated surgically by the sublabial transsphenoidal approach with use of surgical microscope and radiofluroscopic image intensification at the Dept. of Neurosurgery, Yonsei University Medical College. The 2 cases of hormone secreting adenomas were an eosinophilic microadenoma manifestating gigantism and a prolaction secreting adenoma with amenorrhea and galactorrhea. The simplicity of this technique, criteria for the treatment of the hormone secreting and non-secreting adenomas and their biologic behaviors were described and discussed with review of literatures.
Adenoma ; Adenoma, Chromophobe ; Amenorrhea ; Eosinophils ; Female ; Galactorrhea ; Gigantism ; Neurosurgery ; Pituitary Neoplasms ; Pregnancy

We experienced 6 cases of risperidone-induced hyperprolactinemia. Their mean age were 31.2+/- 7.1 years and 1 case was male and 5 cases were females. The reported neuroendocrine side effects were amenorrhea, galactorrhea and gynecomastia. The prolactin levels checked at the reported time of side effects or early stage of drug trial were more than 10 fold of normal level (male : 7.3-16.1 ng/ml, female 7.8-19.6 ng/ml). In male patient with the side effect of gynecomastia, we reduced the dose of risperidone from 6 to 3mg/day which eliminated the symptom 3 month later. As far female patients, risperidone was replaced with the equivalent doses of thioridazine or haloperidol except one female patient to whom risperione was stopped and benzodiazepine was only given. Follow-up results of them were : 1) one female patient was dropped out and 2) the others were all recovered from their neuroendocrine side effects after 3-4 months later.
Amenorrhea ; Benzodiazepines ; Female ; Follow-Up Studies ; Galactorrhea ; Gynecomastia ; Haloperidol ; Humans ; Hyperprolactinemia* ; Male ; Pregnancy ; Prolactin ; Risperidone ; Thioridazine

Escitalopram is one of the most popular selective serotonin reuptake inhibitors (SSRIs) in current use as a first-line treatment for depression. Escitalopram is well-tolerated and rarely associated with serious side effects. Endocrine and reproductive side effects of serotonergic antidepressants are uncommon and galactorrhea is very rarely mentioned among SSRI-related side effects. Serotonin-enhancing antidepressants may result in a rise in prolactin levels through suppression of dopamine neurotransmission. In the present study, we report a case of hyperprolactinemic galactorrhea associated with escitalopram. A 36-year-old woman developed galactorrhea after initiation of escitalopram for depression and was found to have an elevated prolactin level. Escitalopram was discontinued with resolution of the patient's galactorrhea and normalization of her prolactin level.
Adult ; Antidepressive Agents ; Citalopram ; Depression ; Dopamine ; Female ; Galactorrhea ; Humans ; Pregnancy ; Prolactin ; Serotonin Uptake Inhibitors ; Synaptic Transmission

A 29 year old woman came to the hospital due to headache, facial edema, amenorrhea and galactorrhea. On the lahoratory studies, not only hyperprolactinemia and pituitary enlargement, but also primary hypothyroidism were found. Symptomatic and radiological resolution could be achieved by the thyroid hormone replacement only. This case emphasizes the need for evaluation of thyroid status in patients vith presumptive prolacin producing pituitary tumors before initiation of the therapy for hyperprolactinemia.
Adult ; Amenorrhea ; Edema ; Female ; Galactorrhea ; Headache ; Humans ; Hyperprolactinemia* ; Hypothyroidism* ; Pituitary Neoplasms ; Pregnancy ; Thyroid Gland

OBJECT: Risperidone, unlike other atypical antipsychotics, is thought to elevate prolactin levels. This paper examines the relationship of risperidone-induced hyperprolactinemia and the sexual dysfunctions of the patients in the real clinical practice. METHODS: Forty nine patients (male 22, female 27) with 6 month-over risperidone medication were assigned and serum prolactin was assayed in serum by radioimmunometric assay. In the distinction of sex, six adverse events possibly associated with increased prolactin levels were determined by interviewing the patients (poor erection, ejaculatory dysfunction, galactorrhea, decreased libido, orgasmic dysfunction and obesity in male;amenorrhea, vaginal dryness, galactorrhea, decreased libido, orgasmic dysfunction and obesity in female). RESULTS: In 49 patients, thirty six patients (male 15;56%, female 21;95%) showed hyperprolactinemia and twenty two patients (male 13;48%, female 8;36%) had sexual side-effects. Both risperidone dosage per day and duration were not correlated with prolactin levels and adverse events. There was no significant direct correlation between serum prolactin levels and sexual adverse events. CONCLUSION: The risperidone-associated increase in serum prolactin levels was not significantly directly correlated with the emergence of possible prolactin-related adverse events in the real clinical practice. However, our results suggest that risperidone-induced hyperprolactinemia may play a role in sexual dysfunction of female patients.
Antipsychotic Agents ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia* ; Libido ; Obesity ; Orgasm ; Pregnancy ; Prolactin ; Risperidone

Disorders derived from abnormal prolactin(PRL) production are relatively common ingynecological practice. Infertility, menstrual disorders, and galactorrhea are the most frequentmanifestations encountered in women. And, although frequently benign, the disordersoccasionally may have severe consequences.We studied 341 infertile women with normal menstruation(N group) and 105 womenwith oligomenorrhea(O group) and 70 women with secondary amenorrhea(A group), first; to investigate the prevalence of hyperprolactinemia(hPRL) and its clinical etiologies in 3groups, second; to estimate the effect of the bromocriptine(BRMC) treatment in N group,and finally; to obtain an understanding of the underlying physiology and pathoghysiologycoupled with the awareness of the hetrogeneous presentation of hPRL from June, 1994 toDecember, 1996.The results of this study were as follows;1. There were no significant correlations of serum PRL levels by ages in 3 groups.2. The prevalence rates of conventional hPRL(PRL>25ng/mL) were 18.2% in N group,22.9% in O group, 28.6% in A group and were not different among 3 groups(P=0.12).But the rates of PRL>50 ng/mL were 4.7%, 7.6%, 20.0%, respectively and were different(p < 0.01).3. The most common causes of hPRL were prolactinomas(9.3%) and thyroid disorders(4.7%) except the undiagnosed(72.1%).4. The cumulative pregnancy rates of 6~24 months duration were not different betweenBRMC-treated women(33.3%) and BRMC-untreated women(38.9%) in N group(p=0.92).
Female ; Galactorrhea ; Humans ; Hyperprolactinemia* ; Infertility ; Physiology ; Pregnancy ; Pregnancy Rate ; Prevalence ; Thyroid Gland