Spinal cord surgery and galactorrhea: a case report

Galactorrhea Following Minimally Invasive Reoperative Mitral Valve Replacement: An Unexpected Complication

Galactorrhea, or nonpuerperal lactation, is a rare complication that can occur after trauma to the chest wall. Although galactorrhea has been reported after thoracic surgery, it has not been previously noted as a potential outcome following cardiac surgery. We present a unique case of hyperprolactinemic galactorrhea experienced by a 39-year-old nongravid female patient after having undergone reoperative mitral valve replacement via a right minithoracotomy. To the best of our knowledge, this is the first reported case of spontaneous lactation occurring after cardiac surgery.

Prolactin levels and examination with breast ultrasound or mammography

OBJECTIVE

Stresses including surgery, exercise, nipple stimulation, and chest wall injury such as mechanical trauma, burns, surgery, herpes zoster of thoracic dermatomes, hypoglycaemia and acute myocardial infarction cause significant elevation of prolactin levels. The aim of the present study was to evaluate the changes in prolactin level during mammography and ultrasonographic examination.

MATERIALS AND METHODS

Seventy-four premenopausal (mean age, 32.1+/-7.3 y) and 81 post-menopausal women (mean age, 48.3+/-8.9 y) were enrolled into the study. Premenopausal women were evaluated with ultrasound (Senographe 600 T [General Electric]) and post-menopausal women were examined with mammography (Mammomat 3000 [Siemens]). Blood samples for prolactin were taken prior to ultrasound or mammography and 15, 30 and 45 min after ultrasound or mammography.

RESULTS

Mean baseline serum prolactin level was 7.2+/-0.9 ng/ml in premenopausal women before ultrasound. Mean baseline serum prolactin level was 5.4+/-0.4 ng/ml in post-menopausal women before mammography. It was found that there were no significant changes in prolactin levels after ultrasound or mammography (P > 0.05). Mean levels of baseline prolactin were statistically significant higher in premenopausal than in post-menopausal women (P = 0.03).

CONCLUSION

Mammography and ultrasonographic examination have no acute effect on serum prolactin levels in either group. There is no need to wait before measuring the prolactin level after mammographic or ultrasonographic breast examination.

Galactorrhea as the sole presenting symptom of a posterior third ventricular epidermoid cyst

BACKGROUND

Brain tumors that are remote from the sellar and parasellar region rarely produce galactorrhea.

CASE DESCRIPTION

Galactorrhea was the sole presenting symptom in a patient with a posterior third ventricular epidermoid cyst. On investigation, her serum prolactin level was mildly elevated. After radical excision of the tumour, the spontaneous galactorrhea stopped and the serum prolactin level decreased.

CONCLUSION

Because of the clinical and biochemical response seen after surgery, we speculate that the galactorrhea was caused by the presence of the tumor. We postulate that the pressure exerted by the tumor on the diencephalic structures was probably the cause of galactorrhea in our patient.