Prolactinoma

Prolactinoma is one of the possible adenomas of the pituitary gland. It is a benign tumor, the main characteristic of which is increased production and prolactin levels (hyperprolactinemia). Despite its benign nature, it can cause serious complications such as intracranial hypertension or visual impairment.

Symptoms of prolactinoma

In women: In men
 * galactorrhea - excretion of breast milk outside the lactation period
 * amenorrhea – skipping menstruation in at least two cycles
 * impotence and infertility
 * galactorrhea – it is usually not expressed
 * impotence
 * decreased libido
 * Due to the relatively uncharacteristic symptoms of prolactinoma in men, intracranial hypertension often develops and visual symptoms (bitemporal hemianopsia) from chiasma opticum tumor

Elevated prolactin levels do not always indicate prolactinoma. Physiologically, the level can be increased:
They also increase prolactin levels:
 * in the early morning
 * during pregnancy and lactation
 * during exposure to various types of stress
 * estrogen therapy
 * therapy with dopaminergic antagonists

Pseudoprolactinoma
It is a hormonally inactive pituitary adenoma, but its presence disrupts the hypothalamic-pituitary junction, thus preventing the release of dopamine, a natural prolactin antagonist. Thus, hyperprolactinemia occurs again

Treatment and prognosis
Dopaminergic agonists that inhibit prolactin secretion can ideally be used to treat prolactinoma and its symptoms, but some prolactinomas are resistant to this inhibition. The next step is surgical treatment and radiotherapy (these are mainly macroadenomas with a worse prognosis and a tendency to recurrence).

Patients with microprolactinoma (diameter <10 mm) have an excellent prognosis, with 95% of tumors showing no growth after 4 to 6 years. Macroprolactinomas (diameter> 10 mm) often require more aggressive therapy and the prognosis of patients is very individual.

Related articles

 * Hypophysis
 * Function of hypophysis
 * Adenoma of hypophysis

Použitá literatura

 * POVÝŠIL, Ctibor, Ivo ŠTEINER a Pavel DUŠEK, et al. Speciální patologie. 2. vydání. Praha : Galén, 2007. 430 s. ISBN 978-807262-494-2.
 * NEČAS, Emanuel, et al. Patologická fyziologie orgánových systémů II. 2. vydání. 2009. ISBN 978-80-246-1712-1.