Amenorrhea-Galactorrhea Syndrome

The association of secondary amenorrhea and galactorrhea is generally thought to occur in 2 distinct syndromes: the Forbes-Albright syndrome, in which amenorrhea and galactorrhea are accompanied by a pituitary tumor, with or without prior pregnancy, and the Chiari-Frommel syndrome, in which amenorrhea and galactorrhea commence after pregnancy, without associated pituitary tumor. This distinction may be artificial (Rimoin and Schimke, 1971), because the pituitary adenoma may be too small to identify clinically and progression from the benign to the neoplastic syndrome has been documented (Young et al., 1967). Linquette et al. (1967) described mother and daughter with amenorrhea-galactorrhea associated with pituitary adenoma. The mother first developed clinical signs after a pregnancy, whereas the daughter was never pregnant and amenorrhea followed emotional trauma. The sella turcica was enlarged in both and tumor was confirmed by craniotomy. The tumors resembled chromophobe adenomas, but there was fine eosinophilic granulation on tetrachrome staining, as seen in prolactin cells. Since the amenorrhea-galactorrhea syndrome has been described as a part of a multiple endocrine adenomatosis syndrome, it is not certain that the ailment in the mother and daughter reported by Linquette et al. (1967) represented a distinct entity.