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[Prolactin-secreting adenoma]

T Brue1, I Morange, P Jaquet

  • 1Service d'endocrinologie et des maladies métaboliques, Centre hospitalo-universitaire de la Timone, Marseille.

La Revue Du Praticien
|June 15, 1996
PubMed
Summary

Prolactinomas, pituitary tumors causing hyperprolactinemia, lead to hormonal imbalances and mass effects. Dopamine agonists like bromocriptine are effective, with surgery offering a cure for microadenomas.

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Area of Science:

  • Endocrinology
  • Neuro-oncology
  • Reproductive Medicine

Background:

  • Prolactinomas are benign pituitary tumors arising from lactotroph cells.
  • Tumor hypersecretion of prolactin causes hormonal imbalances (hyperprolactinemia).
  • Tumor mass effects can lead to headaches and visual disturbances.

Purpose of the Study:

  • To summarize the clinical presentation and management of prolactinomas.
  • To highlight the impact of hyperprolactinemia and tumor mass.
  • To outline current treatment strategies.

Main Methods:

  • Review of clinical manifestations based on tumor size and prolactin levels.
  • Discussion of diagnostic approaches.
  • Overview of therapeutic options including medical and surgical management.

Main Results:

  • Hyperprolactinemia causes menstrual disturbances, galactorrhea, infertility in women, and sexual dysfunction in men.
  • Microadenomas (<10 mm) may cause headaches; macroadenomas (>10 mm) can compress the optic chiasm, impairing vision.
  • Dopamine agonists normalize prolactin levels, restore gonadal function, and reduce tumor size in most patients.

Conclusions:

  • Prolactinomas require management addressing both hormonal and mass effects.
  • Dopamine agonist therapy is the primary treatment, achieving significant symptom control and tumor shrinkage.
  • Transsphenoidal selective adenomectomy offers a potential cure for microadenomas.

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