Macroprolactinoma in an adolescent female with primary amenorrhoea

Abstract

Paediatric pituitary adenomas are rare in children and adolescents and differ from adults in both clinical presentation and management. We present the case of a 14-year-old female with primary amenorrhoea secondary to a macroprolactinoma, showing a modest radiological and biochemical response to dopamine agonist (DA) therapy. Despite a 10-month duration of increasing DA therapy, initial symptoms of primary amenorrhoea and hyperprolactinaemia persisted, with new symptoms of weight gain, lethargy and low mood. A transsphenoidal resection of the macroprolactinoma was successfully performed, followed by the initiation of additional hormonal therapy. This case explores the unique challenges of treating a macroprolactinoma refractory to medical management in adolescence.