Prolactinoma Signs Symptoms diagnosis and Treatment Lectures by Dr Alamzeb

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Medical education is the process of training and developing future physicians and other health professionals. Prolactinoma Signs Symptoms diagnosis and Treatment • Prolactinoma is the most common type of pituitary tumor (adenoma) that produces a hormone. It makes up about 30% of all pituitary adenomas. • Almost all pituitary tumors are noncancerous (benign). • Prolactinoma may occur as part of an inherited condition called multiple endocrine neoplasia type 1 (MEN 1). • Prolactinoma Overview • This tumor causes the pituitary gland to make too much of a hormone called prolactin. • The major effect of a prolactinoma is decreased levels of some sex hormones — namely, estrogen and testosterone. • A prolactinoma isn't life-threatening. • But it can cause vision difficulties, infertility and other problems. Prolactinoma is the most common type of hormone-producing tumor that can develop in the pituitary gland. • A prolactinoma can usually be treated with medications to bring the prolactin level down into the standard range and shrink the tumor. • In some cases, surgery to remove the tumor might be an option. • Signs Symptoms • A prolactinoma might not cause any signs or symptoms. However, too much prolactin in blood (hyperprolactinemia) can cause symptoms. • Symptoms due to Pressure on surrounding tissues from a large tumor. • Because too much prolactin can disrupt the reproductive system (hypogonadism), some of the signs and symptoms of a prolactinoma are specific to females or males. • In females, prolactinoma can cause: • Irregular menstrual periods or no menstrual periods • Milky discharge from the breasts when not pregnant or breastfeeding • galactorrhea • Painful intercourse due to vaginal dryness • Acne and excessive body and facial hair growth • Reduced sex drive • In males, prolactinoma can cause: • Decreased testosterone levels, leading to low libido (sexual interest) • Rarely enlargement of the breast tissue (gynecomastia) • Rarely, breast milk production • Prolactinomas in men are often very large, and may invade structures adjacent to the normal pituitary gland • Erectile dysfunction • Decreased body and facial hair • Smaller muscles • In both females and males, prolactinoma can cause: • Infertility • Weak and brittle bones that break easily (osteoporosis) • Loss of interest in sexual activity • Pressure from tumor growth can cause • Vision problems • Headache • Reduction of other hormones produced by the pituitary gland • Females who are premenopausal tend to notice signs and symptoms early, when tumors are smaller in size. • This is probably because of missed or irregular menstrual periods. • Females who are postmenopausal are more likely to notice signs and symptoms later, when tumors are larger and more likely to cause headache or vision problems. • Males are also more likely to notice signs and symptoms later. • Diagnosis prolactinoma • Blood tests. Blood tests can show if too much prolactin is being made. • They can also show whether levels of other hormones controlled by the pituitary gland are within the standard range. • A pregnancy test is typically recommended for females of childbearing age. • Brain imaging. Your provider may be able to detect a prolactinoma using a magnetic resonance imaging (MRI) scan of your brain. • Vision tests. These can determine if a prolactinoma is affecting your sight. • Your provider may also refer you for additional testing with a specialist in treating disorders that affect the endocrine glands and hormones (endocrinologist). • Treatment of prolactinoma • Goals in the treatment of a prolactinoma include: • Return the production of prolactin to within the standard range • Reduce the size of the prolactinoma • Restore healthy pituitary gland function • For most people, treatment can eliminate or improve: • Problems caused by increased prolactin levels, such as irregular menstrual periods, infertility and loss of interest in sexual activity • Signs or symptoms from tumor pressure, such as headaches or vision problems • Prolactinoma treatment includes two main therapies: medications and surgery. • Medications prolactinoma • Oral medications known as dopamine agonists are generally used to treat a prolactinoma. • These drugs mimic the effects of dopamine — the brain chemical that controls how much prolactin is made. • Dopamine agonists can decrease the production of prolactin and shrink the size of the tumor. • Drugs can eliminate symptoms for most people with prolactinomas. However, generally need long-term treatment with drugs. • Commonly prescribed drugs include cabergoline and bromocriptine (Cyclosis, Parlodel). • #Pituitary tumor Prolactinoma Signs Symptoms diagnosis and Treatment#

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