Pituitary tumours: the prolactinoma

Area of Science:

• Endocrinology
• Oncology

Background:

• Prolactinomas, pituitary tumors secreting prolactin (PRL), exhibit a higher prevalence than previously estimated.
• Diagnostic criteria for hyperprolactinemia have been streamlined, primarily relying on PRL assays and sellar MRI.

Purpose of the Study:

• To review the epidemiology, diagnosis, and treatment of prolactinomas.
• To highlight recent findings on prolactinoma prevalence and management strategies.

Main Methods:

• Literature review focusing on epidemiology, diagnostic advancements, and therapeutic outcomes for prolactinomas.
• Analysis of recent data on tumor prevalence and patient response to medical therapy.

Main Results:

• The prevalence of prolactinomas is significantly underestimated, potentially 3-5 times higher than earlier reports.
• Macroprolactinaemia requires assessment in asymptomatic hyperprolactinemia cases.
• Long-term dopamine agonist therapy is supported by current evidence.
• Tumor disappearance and normalized PRL levels during treatment correlate with persistent remission post-withdrawal.

Conclusions:

• Prolactinoma diagnosis and management have evolved, with increased awareness of prevalence.
• Dopamine agonist therapy remains a cornerstone, with predictors for sustained remission identified.
• Further research into long-term treatment outcomes and remission criteria is warranted.