Medical Management of a Prolactinoma in a 15-Year-Old Girl

A 15-year-old girl presented to her primary care physician for evaluation of recurrent headaches with occasional blurry vision, periodic white discharge from the left nipple, and primary amenorrhea. Family history was notable for maternal breast cancer. On physical examination, patient was Tanner stage 5 for both pubic hair and breast development and all cranial nerves were grossly intact. Initial laboratory results were as follows: prolactin 1070.0 ng/mL (reference, 3.2-20.0 ng/mL), testosterone 31 ng/dL (reference, < 40 ng/dL), thyroid-stimulating hormone 1.16 mIU/L (reference, 0.50-4.30 mIU/L), and free thyroxine 0.79 ng/mL (reference, 0.9-1.4 ng/mL).

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