38-year-old female, amenorrhoea for 3 months, intermittent galactorrhoea, repeatedly elevated serum prolactin concentration of values between 1250-2100pmol/l (N:female 90-850, male 84-520; highest value around midnight, lowest around 8a.m; episodic spikes). No local symptoms. Initial therapy with somatostatin analogue SMS 201-995 (sandostatin); this caused a volume reduction of the tumour of about 30% (CT). Afterwards transnasal exstirpation of microadenoma (diameter <10mm); soft, grey, partly haemorrhagic tissue.
- Solid tumour tissue without recognizable alveolar structure
- Necrotic areas on some specimen
- Monomorphic cells and nuclei
- Practically no mitoses
- Positive immunohistochemical reaction for prolactin within the cytoplasm and around the nuclei
The prolactinoma, especially in females, is often a microadenoma. It is the most common pituitary tumour.