Resolution of dopamine agonist-resistant hyperprolactinemia by hysterectomy: a case report

Abstract

Prolactin-producing uterine leiomyomas are very rare. Although hyperprolactinemia rapidly improves after removal of such leiomyomas, no preoperative diagnostic test has been established for prolactin-producing uterine leiomyomas. A 45-year-old Japanese woman, gravida 3 para 3, was referred to our hospital for further examination of hyperprolactinemia resistant to a dopamine agonist. A pituitary prolactinoma was undetectable by brain magnetic resonance imaging. A bromocriptine loading test revealed an increased serum prolactin concentration after loading. Examination for the detection of an ectopic prolactinoma revealed a 9.0 cm diameter uterine leiomyoma that had measured 6.6 cm in diameter about six months before the first visit to our hospital. The hyperprolactinemia rapidly improved after hysterectomy. A prolactin-producing uterine leiomyoma should be considered as a possible cause of hyperprolactinemia resistant to dopamine agonists. Responsiveness to dopamine agonists; deterioration of hyperprolactinemia may be diagnostic for prolactin-producing uterine leiomyomas, although further research is required.

Chinese abstract

产生泌乳素的子宫平滑肌瘤非常罕见。尽管这类平滑肌瘤移除后高泌乳素血症很快得到改善, 没有建立针对产生泌乳素子宫肌瘤的术前诊断。一位45岁日本女性, 孕3产3, 因多巴胺激动剂抵抗的高泌乳素血症来我院进一步检查。脑核磁共振成像未监测到垂体泌乳素瘤。溴隐亭负荷试验显示负荷后血清泌乳素浓度增加。检查异位泌乳素瘤发现直径9.0cm子宫平滑肌瘤, 六个月前首次来我院检查时直径为6.6cm。子宫切除术后其高泌乳素血症很快改善。产生泌乳素的子宫平滑肌瘤应被认为是对多巴胺激动剂抵抗的高泌乳素血症的可能原因。尽管需要进一步的研究, 对多巴胺激动剂的反应性；高泌乳素血症的恶化可能对产生泌乳素的子宫平滑肌瘤具有诊断价值。

Keywords:

• Bromocriptine
• hyperprolactinemia
• hysterectomy
• prolactinoma
• uterine leiomyoma

Disclosure statement

The authors report no conflicts of interest in this work.