Idiopathic hyperprolactinemia evolving into macroprolactinoma

摘要

Three patients had idiopathic hyperprolactinemia (IH) diagnosed. Treatment with bromocriptine decreased the serum prolactin level and restored normal menstrual cycles. In all, bromocriptine was stopped and symptoms recurred after 1, 8, and 10 years. Marked hyperprolactinemia developed and large sellar masses were found with computed tomography/magnetic resonance imaging studies. Reinstitution of bromocriptine treatment was effective in two of the three patients. The third required transphenoidal resection of the new resistant lesion, which was unsuccessful. The natural history of IH is known as benign. Nevertheless, these cases demonstrate the need for close clinical follow-up of patients with this condition that does not spontaneously revert to normal.