Prolactinoma induced by estrogen and cyproterone acetate in a male-to-female transsexual
Received 15 December 2009; accepted 27 January 2010. published online 12 March 2010.
Objective
To report a case of a microprolactinoma in a male-to-female transsexual treated with estrogens and cyproterone acetate.
Design
Case report.
Setting
Endocrinology unit in a university hospital.
Patient(s)
A 33-year-old male-to-female transsexual with prolactin level of 10 ng/mL.
Intervention(s)
Treatment with equine-conjugated estrogens (2.5 mg/day, orally) and cyproterone acetate (100 mg/day, orally) during 6 months.
Main Outcome Measure(s)
Her levels of prolactin were repeatedly found to be elevated to a maximum of 133 ng/mL, and magnetic resonance imaging (MRI) revealed a pituitary mass of 5 × 4 × 4 mm.
Result(s)
Discontinuation of the cross-sex hormone treatment did not reduce the levels of prolactin. The use of dopaminergic-agonist therapy normalized them and reduced the size of the microadenoma. After sex-reassignment surgery, she was treated with low-dose estradiol transdermal patches and presented normal levels of prolactin and appropriate levels of 17β-estradiol and testosterone with a stable image in MRI.
Conclusion(s)
We report a case of prolactinoma after treatment with equine-conjugated estrogens and cyproterone acetate. We recommend long-term follow-up observation consisting of a periodic evaluation of prolactin levels and any symptoms suggestive of hyperprolactinemia to detect as early as possible complications derived from cross-sex hormone therapy.
Department of Endocrinology, Doctor Peset University Hospital, Valencia, Spain
Reprint requests: Antonio Hernández Mijares, Ph.D., M.D., Department of Endocrinology, Dr. Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain (FAX: 0034-96-162-24-92).
K.G-M. has nothing to disclose. A.M-G. has nothing to disclose. M.R. has nothing to disclose. M.G-B. has nothing to disclose. A.H-M. has nothing to disclose.
ABSTRACT