A 15-year-old female presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all her pituitary hormones are elevated. The most likely cause is:

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The elevated levels of pituitary hormones suggest a pituitary adenoma, which is a common cause of hormonal dysregulation. The symptoms, including breast discharge and dysmenorrhea, are consistent with an excess of estrogen, which can be caused by a pituitary adenoma that secretes prolactin (a hormone that stimulates breast milk production) and/or follicle stimulating hormone (FSH) (a hormone that stimulates estrogen production). Excessive excitability can also occur due to an excess of thyroid hormone or growth hormone, which may also be elevated in the case of a pituitary adenoma. Hypothalamic hyposecretion, hypothalamic inflammation, and a neurohypophyseal tumor are less likely causes of the symptoms and hormone elevation.

A 15-Year-Old Female Presents with Breast Discharge, Dysmenorrhea, and Excessive