Prolactinoma

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Last update: Sunday, 28 May 2023 at 4.11 pm.

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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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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.

Links[edit | edit source]

References[edit | edit source]

POVÝŠIL, Ctibor – ŠTEINER, Ivo – DUŠEK, Pavel. Special pathology. 2. edition. prague : Galén, 2007. ISBN 978-807262-494-2.

NEČAS, Emanuel. Pathological physiology of organ systems II. 2. edition. 2009. ISBN 978-80-246-1712-1.