Acute lymphoblastic leukaemia presenting with galactorrhoea

See, Wing Shan Queenie; Cheuk, Dkl; Fung, K.; Chan, Godfrey Chi Fung

doi:10.1136/bcr-2012-007461

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…In non-pathological states, prolactin secretion has been demonstrated in decidua, mammary tissue, ovaries, the male reproductive tract, epithelial cells, the immune system, brain, hair follicles, and skin [3]. Extra-pituitary pathological prolactin secretion has been described from perivascular epithelioid tumors [4,5], ovarian tumors [6][7][8], acute lymphoblastic and myeloid leukemias [9][10][11], colorectal adenocarcinoma [12,13], non-Hodgkin's lymphoma [14], renal cell carcinoma [15], renal epitheloid angiomyolipoma [16], cervical cancer [17], and lung cancer [18].…”

Section: Discussionmentioning

confidence: 99%

Uterine Fibroid Causing Hyperprolactinemia and Paradoxical Prolactin Rise with Dopamine Agonist: Case Report and Systematic Review

Upreti

Dray

Elston

2020

SN Compr. Clin. Med.

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Hyperprolactinemia in premenopausal women often presents with amenorrhea, symptoms of estrogen deficiency and subfertility. After exclusion of other common causes and in the context of a normal pituitary MRI scan, hyperprolactinemia is typically deemed "idiopathic." Here we present a case where excess prolactin secretion was attributed to a uterine fibroid and following myomectomy the hyperprolactinemia and its clinical sequelae resolved. Following 6 years of secondary infertility, a 41-year-old woman presented with secondary amenorrhea, expressible galactorrhea, and symptoms of estrogen deficiency. Prolactin levels were consistently raised (1300 mU/L to 2100 mU/L, reference interval < 600 mU/L), and repeated pituitary imaging demonstrated no pituitary abnormality. Prolactin levels demonstrated a paradoxical rise in response to dopamine agonist therapy (2000 mU/L to 5900 mU/L). Imaging demonstrated a uterine fibroid and the patient underwent myomectomy. Following myomectomy, prolactin levels became undetectable, galactorrhea and symptoms of estrogen deficiency resolved, menses returned, and a planned unassisted pregnancy followed. Ectopic prolactin secretion from uterine fibroids is a rare cause of hyperprolactinemia and can result in the same clinical sequelae as pituitary causes. As ectopic prolactin secretion is not under inhibitory control of dopamine, it is usually resistant to, or may rise in response to, dopamine agonist therapy. Prior to a diagnosis of "idiopathic" hyperprolactinemia, ectopic sources of prolactin should be considered.

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Section: Discussionmentioning

confidence: 99%

Uterine Fibroid Causing Hyperprolactinemia and Paradoxical Prolactin Rise with Dopamine Agonist: Case Report and Systematic Review

Upreti

Dray

Elston

2020

SN Compr. Clin. Med.

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Tratamiento de las galactorreas

Canlorbe

Uzan

2017

EMC - Tratado de Medicina

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Paraneoplastic Galactorrhea in Childhood T-ALL: An Evaluation of Tumor-derived Prolactin

Grimes

Mirkheshti

Chatterjee

et al. 2017

Journal of Pediatric Hematology/Oncology

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T-cell acute lymphoblastic leukemia (T-ALL) comprises 15% of childhood leukemia. Although multiagent pulse chemotherapy has improved event-free survival in recent decades, the lack of reliable prognosticators and high rate of relapse remain a challenge. Described is a novel discovery of tumor-derived hyperprolactinemia in childhood T-ALL through a case associated with paraneoplastic galactorrhea. Prolactin production by tumor cells, although a rare phenomenon, is previously demonstrated in several adult cancers and 2 pediatric malignancies with unknown implications. This is the first report demonstrating tumor-derived prolactin in pediatric T-ALL and offers potential as a disease marker and therapeutic drug target.

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Acute lymphoblastic leukaemia presenting with galactorrhoea

Cited by 4 publications

References 13 publications

Uterine Fibroid Causing Hyperprolactinemia and Paradoxical Prolactin Rise with Dopamine Agonist: Case Report and Systematic Review

Uterine Fibroid Causing Hyperprolactinemia and Paradoxical Prolactin Rise with Dopamine Agonist: Case Report and Systematic Review

Tratamiento de las galactorreas

Paraneoplastic Galactorrhea in Childhood T-ALL: An Evaluation of Tumor-derived Prolactin

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