TITLE:
Hyperlactation and Recurrent Postpartum Breast Abscesses Revealing an Unrecognized Prolactinoma: A Case Report and Literature Review
AUTHORS:
Michèle Florence Mendoua, Marcel Gérardin Mbarga, Serge Nyada, Gervais Mounchikpou Ngouhouo, Emile Mboudou
KEYWORDS:
Prolactinoma, Hyperlactation, Breast Abscess, Postpartum, Hyperprolactinemia, Cabergoline
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.11,
November
25,
2025
ABSTRACT: Introduction: Prolactinoma is the most common secreting pituitary tumor. In women of childbearing age, it typically manifests as amenorrhea-galactorrhea. In the postpartum period, its association with pathological hyperlactation is rare but can potentially cause severe breast complications. We report a case of recurrent postpartum breast engorgement and abscesses, complicating hyperlactation induced by an unrecognized prolactinoma. Clinical Observation: The patient was a 32-year-old multiparous woman with no notable medical history, who presented 10 days after an uneventful delivery with abundant, painful lactation, associated with frequent and repeated bilateral engorgements. The condition progressed to recurrent breast abscesses, requiring several surgical drainages and repeated antibiotic treatments. Hormonal assays revealed significant hyperprolactinemia at 358 ng/mL. Pituitary MRI showed a 6.8 mm microadenoma compatible with a prolactinoma. Treatment with cabergoline led to a rapid reduction in lactation but also caused alopecia, prompting early discontinuation of treatment. Discussion: Hyperlactation related to a prolactinoma is an exceptional postpartum phenomenon. Excess prolactin promotes milk stasis and predisposes individuals to engorgements and subsequent iterative breast infections. Diagnosis is based on hormonal assays and pituitary imaging. Cabergoline remains the treatment of choice, enabling the regulation of lactation and prevention of complications. Conclusion: This case illustrates the importance of considering an underlying endocrine disorder in the face of unexplained recurrent postpartum breast abscesses. Screening for hyperprolactinemia should be part of the etiological assessment in any case of persistent pathological hyperlactation after childbirth.