Prolactinoma

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



Symptoms of prolactinoma


In women:
 * galactorrhea – excretion of breast milk outside the lactation period
 * amenorrhea – missing menstruation in at least two cycles
 * impotence and infertility

In men:
 * galactorrhea – is usually not expressed
 * impotence
 * decreased libido
 * due to the relatively uncharacteristic symptoms of prolactinoma in men, the development of intracranial hypertension and visual symptoms (bitemporal hemianopsia) from oppression of the chiasm opticum by the tumor often occurs

Hyperprolactinemia
An elevated prolactin level does not always indicate a prolactinoma. Physiologically the level can be increased:


 * in the early hours of the morning
 * during pregnancy and breastfeeding
 * during exposure to various types of stress

They also increase the prolactin level
 * estrogen therapy
 * dopaminergic antagonist therapy

Pseudoprolactinoma
It is a hormonally inactive pituitary adenoma, but its presence disrupts the hypothalamus-pituitaryconnection, thereby preventing the release of dopamine ,the natural antagonist of prolactin. Hyperprolactinemia will therefore occur again.

Treatment and prognosis
Ideally, dopaminergic agonists, which inhibit prolactin secretion, can 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 relapse).

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
 * Examination of pituitary function
 * Pituitary adenoma