Article Text

  1. D. L. Howell1,
  2. K. R. Rettig1,
  3. S. K. Bhowmick1
  1. 1University of South Alabama, Mobile, AL


Objective To report a very rare and interesting case of pituitary gigantism and hyperprolactemia in a 2½-year-old Caucasian female caused by pituitary macroadenoma.

Method Clinical presentation, physical finding, endocrine evaluation, and radiologic and imaging findings will be discussed. The medical literature review of this rare condition will be presented.

Results A 2½-year-old Caucasian female presented with excessive growth syndrome since 12 months of age. Her height was > 97th percentile (+ 4 SD) and the weight was also > 97th percentile. Her bone age was 3½ years, and her height was at 6 years. Random growth hormone level, insulin-like growth factor 1, IGF binding protein 3, and serum prolactin were extremely elevated. Other pertinent endocrine evaluation was unremarkable, and the MRI of the brain with and without contrast revealed a sellar mass that was 1.9 × 1.8 cm wide in the sella and extending into the suprasellar area measuring 1.4 cm at its widest portion, consistent with a pituitary macroadenoma.

Conclusion Pituitary gigantism secondary to excessive growth hormone secretion from pituitary micro- or macroadenoma is extremely rare in young children. Hyperprolactemia may also present in many patients as a result of plurihormonal adenomas secreting both growth hormone and prolactin. An expanding pituitary adenoma can cause visual field defect and may interfere with the secretion of one or more pituitary hormones. The examination of the visual field and evaluation for other pituitary hormonal status are essential and recommended.

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