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[Prolactin producing adenoma]

N Tamaki1, K Yonezawa

  • 1Department of Neurosurgery, Kobe University School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|October 1, 1993
PubMed
Summary

Prolactin-secreting pituitary adenomas (prolactinomas) are common and can cause hyperprolactinemia. High-resolution MRI is key for diagnosis, while surgery offers a cure for many, especially with advanced techniques for infiltrating tumors.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Radiology

Context:

  • Prolactin-secreting tumors (prolactinomas) are the most frequent pituitary adenomas, accounting for approximately 40% of cases.
  • Hyperprolactinemia, particularly levels under 200 ng/ml, can stem from various sellar lesions, complicating diagnosis.
  • High-resolution Magnetic Resonance (MR) imaging is now the primary diagnostic tool, superseding CT scans for pituitary tumors.

Purpose:

  • To differentiate true prolactinomas from other causes of hyperprolactinemia.
  • To outline the diagnostic advantages of MR imaging in visualizing pituitary adenomas.
  • To discuss therapeutic strategies based on tumor size and associated symptoms.

Summary:

  • MR imaging aids in identifying microadenomas as areas of decreased signal intensity and delineates the relationship of macroadenomas to critical structures like the optic nerve and cavernous sinus.
  • Surgical resection, particularly transsphenoidal adenomectomy, is a primary treatment, with high cure rates for microadenomas.
  • For macroadenomas, surgery cures about 50% but significantly improves vision and reduces medication needs; radical resection of infiltrating tumors enhances curative rates.

Impact:

  • Accurate diagnosis through advanced imaging leads to appropriate treatment selection.
  • Effective surgical management improves patient outcomes, reduces medication dependency, and preserves visual function.
  • Improved surgical techniques, including radical resection, address tumor infiltration, increasing cure rates for prolactinomas.

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