Prolactin secreting adenoma in 22 men

The authors report on 22 men with a prolactin secreting adenoma. Clinical symptomatology included associated signs of tumoral compression with varying degrees of hypogonadism. Endocrinological evaluation disclosed hyperprolactinemia in all cases but one, and hypopituitarism in 10 of 22 cases. Of the 22 patients, 21 underwent transsphenoidal microsurgery (two of whom underwent a second procedure by the infrafrontal approach) and in one case surgery was performed by the infrafrontal route. Diagnosis was confirmed by immunocytochemical evaluation of tumoral tissue. Prolactin levels returned to normal in 32% of cases after operation and became normal after complementary bromocriptine therapy in 54.5% of cases. However, normal prolactin secretion was not consistently accompanied by a return to normal of gonadotropin regulation. In three patients radiotherapy was not effective. The latter treatment should be limited to the very rare cases of postoperative resistance to bromocriptine.