Pituitary prolactin-secreting macroadenoma combined with bilateral breast cancer in a 45-year-old male

We describe an unusual case of bilateral breast cancer synchronous with pit uitary macroprolactinoma in a young male. Up to date, only very few of such cases have been described worldwide and to our knowledge this is the first one in which both breast cancer and pituitary macroadenoma have been found together at the time of presentation. A 45-year-old male was diagnosed as having a pituitary macroprolactinoma and bilateral breast cancer on the bas is of hypogonadism (testosterone 2.9 pmol/l) with very high levels of prola ctin (33,100 U/l), typical neuroradiologic finding of a pituitary macroaden oma, marked bilateral gynecomastia with mammographic pattern highly suspect ed for cancer and subsequent hystological confirmation. Bilateral mastectom y was performed and medical therapy with bromocriptine 10 mg/day was starte d. After 2-year follow-up the patient is disease-free. Hormonal, neuroradio logical and oncological patterns are all negative or markedly improved. We stress the importance of prolactin for its possible biological effects on b reast cancer induction or growth. Moreover in any case of hyperprolactinemi a we suggest a mammographic examination and, in the case of breast cancer, at least a baseline hormonal profile. (J. Endocrinol. Invest. 24: 454-459, 2001) (C) 2001, Editrice Kurtis.