A good wife, but never a mother

Prolactinomas are the commonest pituitary tumour. They are more frequent in women and account for up to 15% of patients with amenorrhoea (through secondary gonadotrophin suppression). Here we present two patients with previously unrecognized giant prolactinomas, one of whom is probably unique in having radiological evidence of progression from micro to macro prolactinoma in the absence of treatment. Both were being considered for hormone replacement therapy. These tumours are known to be oestrogen sensitive and potentially life threatening. Both had been investigated for amenorrhoea prior to the availability of prolactin assays; no other cause had been found. Amenorrhoeic patients investigated prior to the early 1970s should be reviewed with this in mind. Patients with untreated microprolactinomas should probably be monitored indefinitely.