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[Prolactin microadenoma in men. Study of 14 cases]
A P Gimenez-Roqueplo1, M Dupuy, O Delalande
1Service de Neuro-Chirurgie, CMC Foch, Suresnes.
Abstract:
Macroprolactinomas have been well documented in men over the past several years. By contrast, to the best of our knowledge, there have been no reports of microprolactinomas in men. We describe here 14 cases of microprolactinomas occurring in male patients (14 to 53 years old) and discovered on the basis of endocrine symptoms. Nine patients complained of impotence and/or decreased libido, 8 had gynecomastia with or without galactorrhea, 1 had undergone incomplete puberty. All patients had hyperprolactinemia (225 +/- 65 micrograms/l, mean +/- SEM, N less than 13 micrograms/l); plasma testosterone levels were low in 9 (162 +/- 33 ng/dl, mean +/- SEM; N = 308 - 876 ng/dl), while plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels and their responses to LH-releasing hormone (LHRH) were normal in all cases. Among the 14 patients, 12 had no hypopituitarism and 2 had only partial corticotrope insufficiency; none had visual disturbances and only one complained of headaches. The sella turcica was normal in size and shape in 2 cases but a double floor and/or a thinner part of the floor was observed in 12. CT scan of MRI demonstrated in all cases an intrasellar microadenoma with a mean size of 7 mm (range, 3 to 10 mm) and no preferential localization. One patient was treated with bromocriptine, while the others underwent surgery via the transsphenoidal route. Immunocytochemistry demonstrated immunoreactive-prolactin (IR-PRL) cells in all the adenomas. Surgery resulted in normalization of plasma PRL in 11 of the 13 patients and in lowering PRL levels in the others 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
This study reports on 14 male patients with microprolactinomas, a rare condition characterized by small pituitary tumors. Findings highlight endocrine symptoms and successful treatment outcomes, advancing understanding of male pituitary adenomas.
Area of Science:
- Endocrinology
- Neuroscience
- Oncology
Context:
- Macroprolactinomas are well-documented in men, but microprolactinomas have not been previously reported.
- This study investigates a series of male patients diagnosed with microprolactinomas.
Purpose:
- To describe the clinical presentation, hormonal profiles, and diagnostic findings of microprolactinomas in men.
- To evaluate the treatment outcomes for male patients with microprolactinomas.
Summary:
- Fourteen male patients (aged 14-53) with microprolactinomas presented with endocrine symptoms including impotence, decreased libido, and gynecomastia.
- All patients exhibited hyperprolactinemia, with low testosterone levels in nine. Imaging confirmed intrasellar microadenomas (mean size 7 mm).
- Treatment via bromocriptine or transsphenoidal surgery resulted in normalized or lowered prolactin levels in most patients.
Impact:
- This research establishes the existence and clinical characteristics of microprolactinomas in men.
- It provides evidence for effective treatment strategies, improving patient management and outcomes for this rare pituitary tumor.