Ectopic hyperprolactinemia resulting from an ovarian teratoma

Prolactin, a hormone secreted by the pituitary gland, is associated with lactation, or the secretion of breast milk. Normally, elevated levels of prolactin in nonpregnant female patients indicate a malfunction of the pituitary gland. However, a case history is presented in which, after treatment to relieve symptoms of secondary amenorrhea (absence of menstruation) and galactorrhea (spontaneous flow of breast milk) caused by elevated prolactin (hyperprolactinemia), the condition returned. The patient, a 25-year-old women, was initially diagnosed with a pituitary tumor and treated surgically. The procedure was not entirely successful and was followed-up with drug therapy. After apparent relief of symptoms for about two years, prolactin levels were again found to be elevated and galactorrhea returned. An ovarian teratoma (tumor) was noted during routine examination. When the tumor was removed, tissue examination revealed the presence of prolactin. After removal of the tumor, the patient's prolactin level returned to normal. The authors are not aware of any other documented cases of hyperprolactinemia associated with teratoma. It was believed that this patient's pituitary function was not the cause of the initial prolactin irregularity, although it is possible that pituitary irregularity was a contributing factor. A variety of suggestions which outline possible courses that this patient's condition actually followed are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)