Management of pituitary macroprolactinoma in a 27-year-old male patient from Taiwan.

OBJECTIVES

The aim is to document the success of bromocriptine pharmacotherapy in a patient with gigantoprolactinoma.

RESULT: The management of the patient was not appropriate at the beginning, because he underwent an operative therapy after the ophthalmological examination and MR without previous internal--endocrinological examination and pharmacotherapy. The endocrinologist participated in the patient management later, after the unsuccessful operative and when the patient's status was characterized by hyperprolactinaemia 15,000 ug/l and by hypopituitarism. Bromocriptine therapy immediately at the beginning would enable the patient to avoid several surgical interventions and subsequent complications with a high probability.

CONCLUSION

The case report presents the failures at the beginning of diagnostic and therapeutic management of the patient with hyperprolactinaemia due to macroprolactinoma. It is both the example and the proof of irretrievability of general internal medicine, endocrinology and other internal disciplines in clinical practice. It confirms the integrating and coordinating function of the internal medicine specialist in clinical medicine (Tab. 1, Ref. 13).