Prolactinomas in adolescent and elderly patients-A comparative long-term analysis

Area of Science:

• Endocrinology
• Oncology
• Neuroendocrinology

Background:

• Prolactinomas, the most common pituitary adenomas, are seldom studied in adolescent-onset (AO) and elderly-onset (EO) populations.
• Understanding long-term therapeutic outcomes in these extreme age groups is crucial for tailored management strategies.

Purpose of the Study:

• To investigate and compare long-term endocrinological outcomes in adolescent-onset (AO) and elderly-onset (EO) prolactinoma patients.
• To evaluate the long-term dependence on dopamine agonist (DA) therapy in these cohorts.

Main Methods:

• Retrospective comparative study of 108 prolactinoma patients with a follow-up of at least 4 years.
• Analysis of clinical, radiological, and biochemical characteristics at diagnosis and last follow-up.
• Comparison of longitudinal outcomes between AO, EO, and middle-aged cohorts, with calculation of risk factors for long-term DA dependence.

Main Results:

• Elderly-onset (EO) patients, compared to adolescent-onset (AO) patients, were predominantly male and presented with higher prolactin (PRL) levels and BMI.
• A significant positive correlation was observed between PRL levels and age or BMI.
• Remission rates were high (83% overall), with no significant difference between AO (90%) and EO (70%) cohorts. Continuation of DAs was required in 40% of AO and 70% of EO patients.

Conclusions:

• Long-term control of hyperprolactinemia and hypogonadism is achievable in both AO and EO prolactinoma patients.
• Elderly-onset prolactinoma is an independent predictor of long-term dependence on dopamine agonists.
• Long-term monitoring is recommended, particularly for elderly-onset patients, due to the frequent need for continued DA therapy.