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

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

Venlafaxine is a serotonergic and noradrenergic reuptake inhibitor which is used for the treatment of depression. We report a case of galactorrhea in a patient with major depressive disorder after starting treatment with venlafaxine. In particular, we discuss the course of hyper and normoprolactinemic galactorrhea. We managed this side effect initially by dose reduction and further by switching to essitalopram. Physicians should be aware of endocrinologic side effects such as galactorrhea during the serotonin and noradrenaline reuptake inhibitor treatment.
Depression ; Depressive Disorder, Major ; Female ; Galactorrhea* ; Humans ; Norepinephrine ; Pregnancy ; Prolactin ; Serotonin ; Venlafaxine Hydrochloride*

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

Galactorrhea, as an adverse effect of psychotropic medications, usually develops due to high dose of antipsychotics. Selective serotonin reuptake inhibitors (SSRIs) have also been reported to be related to galactorrhea. To the best of our knowledge, no previous study reported galactorrhea with methylphenidate (MPH) use. Hereby, we report a case of an adolescent girl who developed galactorrhea after increasing his modifed-release oral MPH to 50 mg/day while under treatment of sertraline and very low dose haloperidol.
Adolescent* ; Antipsychotic Agents ; Female ; Galactorrhea* ; Haloperidol ; Humans ; Methylphenidate* ; Pregnancy ; Serotonin Uptake Inhibitors ; Sertraline

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

Carbamazepine (CBZ) may alter the secretion of prolactin (PRL), however, there is no report about hyperprolactinemia with galactorrhea induced by CBZ medication. A 30-year-old woman presented with galactorrhea. She had been treated with CBZ for three years and hormonal study revealed increased serum PRL levels. Sella MRI showed no evidence of pituitary lesion. Two months after changing CBZ to oxcarbazepine, galatorrhea was improved and the serum PRL level was normalized.
Adult ; Carbamazepine* ; Female ; Galactorrhea* ; Humans ; Hyperprolactinemia* ; Magnetic Resonance Imaging ; Pregnancy ; Prolactin

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

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