<prompt> 35 year old female patient Radha having children aged 5 and 6 years has history of amenorrhea and galactorrhea. Blood examination reveals increased prolactin. CT of head is likely to reveal:Pituitary adenomaCraniopharyngiomaSheehans syndromePinealoma  <response>: Patient is presenting with amenorrhea; galactorrhea with raised prolactin levels. So lets rule out some of the options:Sheehans Syndrome In Sheehans syndrome there is failure of lactation due to ischemic necrosis of anterior pituitary and not galactorrhea so, option c ruled out.Pinealoma: If you go through the list of causes of hyperprolactinemia given in Harrison 17thed p 2205; Table 333-8 - Pinealoma is not one of the causes. as there is no reason for a pineal gland tumor to raise prolactin levels, ruling out option d.That leaves us with 2 options:Pituitary adenoma and craniopharyngiorma: Both are pituitary tumors which can present with amenorrhea galactorrhea, and raised prolactin levels.Now comes the age factor - Craniopharyngiomas present usually before 20 years Harrison 1762ed p 2201 of age and so by exclusion: Option a i.e. Pituitary adenoma seems more likely as the cause.In patients with both galactorrhea and amenorrhea approximately two-thirds will have hyperprolactinemia, in that group approximately one third will have a pituitary adenoma.So, pituitary adenoma is more common than craniopharyngioma and this confirms our answer. 