What Is It?
Prolactinoma is a pituitary adenoma
which secretes prolactin. Pituitary adenomas are benign tumors that arise from the anterior pituitary gland.
Prolactin is a hormone which is important for development of mammary gland tissue and secretion of milk in lactating women. At the same time it causes inhibition of the menstrual cycle. In patients who have a prolactinoma, there is an abnormally high level of prolactin secreted. This can lead to infertility, loss of normal menstruation, breast enlargement and secretion of a milk-like secretion from the nipples in women. This clinical syndrome is sometimes referred to as amenorrhea-galactorrhea. In men it can lead to impotence, enlargement of the breasts (gynecomastia), and secretion of a milk-like secretion from the nipples.
What Types of Symptoms Are Typical?
In women, high levels of prolactin can cause infertility, loss of normal menstruation, breast enlargement and secretion of a milk-like secretion from the nipples in women. This clinical syndrome is sometimes referred to as amenorrhea-galactorrhea.
In men it can lead to impotence, enlargement of the breasts (gynecomastia), and secretion of a milk-like secretion from the nipples.
In addition to this clinical syndrome associated with secretion of prolactin, these pituitary adenomas can cause other symptoms typical of a pituitary adenoma including headache, visual changes and hypopituitarism.
How Is The Diagnosis Typically Made?
In addition to the standard imaging and blood tests done for all pituitary adenomas
, a prolactin secreting tumor will be confirmed by very high blood levels of prolactin.
What Are Some Common Treatments?
Prolactinoma is a unique pituitary adenoma in that there exist drugs which can help control the tumor in some patients. These medications, called dopamine agonists (bromocriptine and cabergoline), actually inhibit the tumor cells and decrease their secretion of prolactin and can even lead to decreased size of the tumor. While this effect can be profound in some patients, it may not be as effective in others.
In very large tumors or in tumors which are not adequately controlled by dopamine agonist medications, surgery will sometimes also be recommended. As with other pituitary adenomas, these are generally approached through a transsphenoidal surgery through the nasal passage.
Each tumor and patient is different, so it is hard and inappropriate to make generalizations about what treatment plan is most appropriate. Each patient should discuss their options with their own physician team.
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This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.