Galactorrhea-Amenorrhea Syndrome: Follow-up of Forty-Five Patients After Pituitary Tumor Removal

Abstract

Forty-five patients with galactorrhea-amenorrhea were followed during a period of 1-8 yr (mean 3.1) after transsphenoidal prolactinoma removal. The ratios of patients who appear to be cured to the total numbers treated were: 20 patients of 27 with grade I tumors; 6 of 10 with grade II; 2 of 5 with grade III; and none with grade IV tumors. Six patients with normal prolactin levels 1 wk postoperatively had relapse later, as did 3 with normal prolactin levels 2 mo. postoperatively. A normal prolactin level 6 mo. postoperatively predicted ultimate cure. The 19 pregnancies that occurred in 15 patients, 4 with high prolactin levels, were uneventful. Prolactin rose normally with pregnancy and returned to prepregnancy level in all but 1 patient. Prolactin responses to stimulation tests were blunted for 6 mo. after successful tumor removal. By 1 yr, responses to thyrotropin releasing hormone and metoclopramide tests were returning to normal, although responses to chlorpromazine and hypoglycemia remained blunted. The postoperative inhibition of normal lactotropes for 6 mo. is suggested. Ultimate cure cannot be determined before 6 mo. and conception should be deferred until then.