Prolactinomas in children and adolescents--consequences in adult life

Prolactinomas in children and adolescents are rare. However, they represent, together with corticotropinomas, the most frequent types of pituitary tumors in adolescence. Most prolactin-secreting pituitary tumors are microprolactinomas but many, and particularly those in men, are macroadenomas. The clinical findings that would usually project into the adult life of patients, in other words the issue of transitory endocrinology from childhood to adulthood, are menstrual irregularities, infertility, short stature, osteopenia and/or osteoporosis, and sometimes psychometric abnormalities. The therapy of choice for both macro- and microprolactinomas is one of the new dopamine agonists, such as quinagolide or cabergoline. Recent evidence-based data have clearly promoted cabergoline as the first-line treatment. Cabergoline may normalize prolactin secretion, restore fertility in women and men. and induce tumor shrinkage. Today, transsphenoidal surgery should be considered only in patients with a large extrasellar extension.