Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. Which of the following is a most likely diagnosis in this case –
Correct Answer: Pituitary macroadenoma
Description: A 35 year old woman complaining of amenorrhoea — galactorrhoea syndrome along with visual field defects confirms the diagnosis of pituitary macrodenoma (prolactinoma)
Amenorrhoea and galactorrhoea results due to increased secretion of prolactin.
Headache and visual field defects are seen due to mass effect of the tumours on the optic nerve.
Now, the closest d/d of prolactinoma i.e. craniopharyngioma
Bimodal age of incidence with one peak in childhood and the other in old age at 60 years.
These tumours are suprasellar in location and the symptoms are produced due to mass effect of tumour either on the pituitary or optic chiasm. (It does not secrete any hormone)
"Craniopharyngioma will never produce the Amenorrhoea galactorrhoea syndrome. Craniopharyngioma does not secrete any hormone."
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