Excessively high prolactin level in a patient with a nonprolactin-secreting adenoma - Case report

The authors report the case of a 48-year-old woman who presented with a non prolactin-secreting adenoma and a preoperative prolactin level of 662 ng/ml . The patient's neoplasm subsequently enlarged despite normalization of her prolactin level with dopamine agonist therapy. Hyperprolactinemia, with le vels of prolactin as high as 150 ng/ml, is commonly associated with sellar tumors and is attributed to disruption of the normal delivery of-dopamine t o the adenohypophysis. The prolactin level found in this patient represents the highest level attributed to the stalk-section effect reported in the l iterature and underscores the need for repeated radiographic assessment of patients who are undergoing treatment with bromocriptine and have prolactin levels in the 25 to 1000 ng/ml range.