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Prolactinoma: Treatment, symptoms, advice & help

About prolactinoma

Prolactinoma is a prolactin- secreting benign tumour of the pituitary gland and is the most common tumor of the pituitary gland. Based on size, a prolactinoma can be classified as a microprolactinoma (<10 mm diameter) or macroprolactinoma (>10 mm diameter).

Prolactinoma: Incidence, age and sex

The disorder affects more than twice as many girls as boys. With the advent of MRI, more of these tumours, particularly microadenomas (<1cm), are being detected.

Signs & symptoms of prolactinoma: Diagnosis

The most common presenting manifestations are headache, amenorrhea, and galactorrhea. Prolactin levels may be moderately (40 – 50 ng/mL) or markedly (10,000 – 15,000 mg/mL) elevated. Most prolactinomas in children are large (macroadenomas), cause the sella to enlarge, and in some cases cause visual field defects.

Causes and prevention of prolactinoma:

The cause of pituitary tumours remains unknown. Most pituitary tumours are sporadic—they are not genetically passed from parents to offspring.

Prolactinoma: Complications

Approximately 1/3 of patients with macroadenomas develop hypopituitarism, particularly GH deficiency. Hyperprolactinemia can cause reduced oestrogen production in women and reduced testosterone production in men. Even a year or two without oestrogen/testosterone can compromise bone strength and cause osteoporosis.

Prolactinoma: Treatment

Treatment has been surgical resection by transfrontal or transphenoidal approach. Prolactinoma can also be effectively managed medically in most patients by treatment with bromocriptine or long acting cabergoline. About 80% of adult patients respond with shrinkage of the tumour and marked decreased in serum prolactin levels. Patients must protect themselves from osteoporosis by increasing exercise and calcium intake through diet or supplementation, and by avoiding smoking.