Prolactinoma

Prolactinoma is a type of pituitary tumor that produces excess prolactin, a hormone that stimulates breast development and milk production in women. It is the most common type of functioning pituitary tumor, accounting for about 30-40% of all pituitary tumors.

Causes and Risk Factors

The exact cause of prolactinoma is not known, but it is thought to be related to genetic mutations or abnormalities in the pituitary gland. Risk factors include:

• Family history of pituitary tumors
• Previous head trauma or radiation therapy
• Certain genetic disorders, such as multiple endocrine neoplasia type 1 (MEN1)

Symptoms

The symptoms of prolactinoma can vary depending on the size and location of the tumor, as well as the level of prolactin production. Common symptoms include:

• Galactorrhea (spontaneous milk production)
• Amenorrhea (absence of menstrual periods) in women
• Erectile dysfunction or decreased libido in men
• Headaches and visual disturbances, such as blurred vision or double vision
• Infertility or difficulty conceiving

Diagnosis

The diagnosis of prolactinoma is typically made based on a combination of clinical evaluation, laboratory tests, and imaging studies. These may include:

• Blood tests to measure prolactin levels
• Magnetic resonance imaging (MRI) or computed tomography (CT) scans to visualize the pituitary gland and tumor
• Visual field testing to assess for any visual disturbances

Treatment

The treatment of prolactinoma depends on the size and location of the tumor, as well as the level of prolactin production. Treatment options may include:

• Medications, such as dopamine agonists (e.g., bromocriptine or cabergoline), to reduce prolactin production
• Surgery, such as transsphenoidal surgery, to remove the tumor
• Radiation therapy, such as stereotactic radiosurgery, to shrink the tumor

Complications

If left untreated, prolactinoma can lead to several complications, including:

• Pituitary apoplexy (sudden bleeding into the pituitary gland)
• Cerebrospinal fluid leak
• Visual loss or blindness
• Hypopituitarism (deficiency of one or more pituitary hormones)

Prognosis

The prognosis for prolactinoma is generally good, with most patients experiencing significant improvement in symptoms and quality of life with treatment. However, the tumor can recur, and long-term follow-up is necessary to monitor for any changes in prolactin levels or tumor size.

Frequently Asked Questions (FAQs)

What is a prolactinoma?
A type of pituitary tumor that produces excess prolactin.

What are the symptoms of prolactinoma?
Headaches, vision problems, infertility, and hormonal imbalances.

How is prolactinoma diagnosed?
Blood tests and MRI scans.

What causes prolactinoma?
Unknown, but may be related to genetic factors.

Is prolactinoma cancerous?
Usually benign, but can be invasive.

How is prolactinoma treated?
Medication, surgery, or radiation therapy.

Can prolactinoma be cured?
Often treatable, but may require ongoing management.

What are the risks of untreated prolactinoma?
Vision loss, infertility, and osteoporosis.

Can prolactinoma affect fertility?
Yes, high prolactin levels can disrupt reproductive hormones.

Is prolactinoma common?
Rare, affecting about 1 in 10,000 people.