Fertility and sterility · 2010
Prolactinoma induced by estrogen and cyproterone acetate in a male-to-female transsexual.
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García-Malpartida Katherine, Martín-Gorgojo Alejandro, Rocha Milagros, Gómez-Balaguer Marcelino, Hernández-Mijares Antonio
Аннотация
OBJECTIVE: To report a case of a microprolactinoma in a male-to-female transsexual treated with estrogens and cyproterone acetate.
DESIGN: Case report.
SETTING: Endocrinology unit in a university hospital.
PATIENT(S): A 33-year-old male-to-female transsexual with prolactin level of 10 ng/mL.
INTERVENTION(S): Treatment with equine-conjugated estrogens (2.5 mg/day, orally) and cyproterone acetate (100 mg/day, orally) during 6 months.
MAIN OUTCOME MEASURE(S): Her levels of prolactin were repeatedly found to be elevated to a maximum of 133 ng/mL, and magnetic resonance imaging (MRI) revealed a pituitary mass of 5x4x4 mm.
RESULT(S): Discontinuation of the cross-sex hormone treatment did not reduce the levels of prolactin. The use of dopaminergic-agonist therapy normalized them and reduced the size of the microadenoma. After sex-reassignment surgery, she was treated with low-dose estradiol transdermal patches and presented normal levels of prolactin and appropriate levels of 17beta-estradiol and testosterone with a stable image in MRI.
CONCLUSION(S): We report a case of prolactinoma after treatment with equine-conjugated estrogens and cyproterone acetate. We recommend long-term follow-up observation consisting of a periodic evaluation of prolactin levels and any symptoms suggestive of hyperprolactinemia to detect as early as possible complications derived from cross-sex hormone therapy.
DESIGN: Case report.
SETTING: Endocrinology unit in a university hospital.
PATIENT(S): A 33-year-old male-to-female transsexual with prolactin level of 10 ng/mL.
INTERVENTION(S): Treatment with equine-conjugated estrogens (2.5 mg/day, orally) and cyproterone acetate (100 mg/day, orally) during 6 months.
MAIN OUTCOME MEASURE(S): Her levels of prolactin were repeatedly found to be elevated to a maximum of 133 ng/mL, and magnetic resonance imaging (MRI) revealed a pituitary mass of 5x4x4 mm.
RESULT(S): Discontinuation of the cross-sex hormone treatment did not reduce the levels of prolactin. The use of dopaminergic-agonist therapy normalized them and reduced the size of the microadenoma. After sex-reassignment surgery, she was treated with low-dose estradiol transdermal patches and presented normal levels of prolactin and appropriate levels of 17beta-estradiol and testosterone with a stable image in MRI.
CONCLUSION(S): We report a case of prolactinoma after treatment with equine-conjugated estrogens and cyproterone acetate. We recommend long-term follow-up observation consisting of a periodic evaluation of prolactin levels and any symptoms suggestive of hyperprolactinemia to detect as early as possible complications derived from cross-sex hormone therapy.