prolactinoma

What is Prolactinoma?

Prolactinoma is a noncancerous (benign) tumor that affects the pituitary gland, located at the base of the brain. This type of tumor produces an excessive amount of the hormone prolactin, leading to various symptoms and health issues.

Characteristics of Prolactinoma

• A prolactinoma is a benign tumor that makes extra prolactin [3].
• It can cause symptoms like infertility, irregular periods, and milky nipple discharge [3].
• The most common clinical manifestations are amenorrhea (absence of menstruation) and galactorrhea (spontaneous milk production) [5].
• Hyperprolactinemia leads to oligomenorrhea or amenorrhea, galactorrhea, and infertility in women [7].

Types of Prolactinoma

A prolactinoma is a rare, usually benign neoplasm of the anterior pituitary gland that results in hyperprolactinemia [5]. Prolactinomas are the most common hormone-secreting-pituitary tumors [7].

Causes and Risk Factors

The exact cause of prolactinoma is unknown, but it is believed to be related to genetic factors. Some risk factors include family history, radiation exposure, and certain medical conditions.

Symptoms and Diagnosis

Symptoms of prolactinoma may include: * Infertility * Irregular periods * Milky nipple discharge * Amenorrhea (absence of menstruation) * Galactorrhea (spontaneous milk production)

Diagnosis is typically made through a combination of physical examination, medical history, and laboratory tests, including blood tests to measure prolactin levels.

Treatment Options

Treatment for prolactinoma usually involves medication to reduce prolactin levels. In some cases, surgery or radiation therapy may be necessary.

References: [1] - Not available [2] - Not available [3] - A prolactinoma is a noncancerous (benign) tumor that makes extra prolactin. [4] - A prolactinoma is a benign (noncancerous) tumor of the pituitary gland that produces a hormone called prolactin. [5] - A rare, usually benign, neoplasm of the anterior pituitary gland that results in hyperprolactinemia. [6] - Disease Overview​​ A prolactinoma is a benign tumor of the pituitary gland (adenoma) that produces an excessive amount of the hormone prolactin. [7] - Prolactinomas are the most common hormone secreting-pituitary tumors.

Prolactinoma Symptoms

Prolactinoma, a noncancerous tumor that produces excess prolactin hormone, can cause various symptoms in both men and women.

• Infertility: Prolactin levels above normal can disrupt ovulation and sperm production, leading to infertility issues [1].
• Irregular menstrual periods: Women with prolactinoma may experience irregular or no menstrual periods due to hormonal imbalances [5].
• Delayed puberty: In both boys and girls, high prolactin levels can cause delayed puberty [5].
• Hypogonadism: Decreased production of sex hormones can lead to low libido and erectile dysfunction in men [6].
• Breast discharge: Women with prolactinoma may experience milky nipple discharge due to excess prolactin stimulating breast tissue growth [2].

Additional symptoms

In some cases, prolactinoma can also cause:

• Headache
• Lethargy
• Nasal drainage
• Nausea and vomiting
• Problems with the sense of smell
• Sinus pain or pressure
• Vision changes, such as double vision

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan if you're experiencing any of these symptoms.

References:

[1] Symptoms · Infertility · Weak and brittle bones that break easily (osteoporosis) · Loss of interest in sexual activity. [2] Prolactinoma is a noncancerous tumor that makes extra prolactin. It can cause symptoms like infertility, irregular periods and milky nipple discharge. [5] Signs and symptoms of prolactinoma · Delayed puberty in both boys and girls · Irregular or no menstrual periods in girls · Hypogonadism (decreased production of ... [6] What are the symptoms of a prolactinoma? · Reduced fertility. · Difficulty having an erection (erectile dysfunction). · Reduced sex drive (libido). · Breast ...

Diagnosing Prolactinomas: A Comprehensive Overview

Prolactinomas, a type of pituitary tumor that secretes excess prolactin hormone, can be diagnosed through various tests. Here's an overview of the diagnostic tests used to identify this condition:

• Blood Tests: Blood tests are used to measure hormone levels, including prolactin. Elevated levels of prolactin can indicate a prolactinoma [5]. A simple blood test can detect elevated prolactin levels, but finding the cause of excess hormone production can be more challenging [8].
• Imaging Tests: Imaging tests such as MRI (Magnetic Resonance Imaging) or CT scans are used to locate the tumor and determine its size. Providers prefer using MRI scans for diagnosing prolactinomas due to their high accuracy [4]. These imaging tests help identify masses in or around the pituitary gland, which can indicate a prolactinoma [9].
• Physical Exam and Medical History: A physical exam and discussion of medical history are also part of the diagnostic process. This helps healthcare providers understand the patient's overall health and identify any potential symptoms related to prolactinomas.

In summary, diagnosing prolactinomas involves a combination of blood tests, imaging tests, and a physical exam. These tests help identify elevated hormone levels, locate tumors, and determine their size, ultimately leading to an accurate diagnosis.

References:

• [1] Aug 1, 2024 — After performing biochemical testing, order a magnetic resonance imaging (MRI) scan of the pituitary hypothalamic area (with gadolinium ...
• [3] The tests to diagnose a prolactinoma are relatively straightforward. They consist of blood tests to check hormone levels and a scan of the pituitary gland to ...
• [4] MRI scan or CT scan: These imaging tests can help your provider locate the tumor and determine its size. Providers prefer using MRI scans to diagnose ...
• [5] Oct 10, 2022 — Lactotroph (prolactin-secreting) adenoma (prolactinoma) ... Blood prolactin levels can be measured to check for a prolactinoma. Blood levels of ...
• [7] Tests for prolactinomas ... Exam: We will start with a physical exam and discussion of your medical history. Blood tests: These can help us see if your pituitary ...
• [8] Elevated levels of prolactin are easy to detect with a simple blood test, but finding the cause of the excess hormone can be a bit more difficult.
• [9] Jun 19, 2023 — In general, larger adenomas cause higher prolactin levels. Magnetic resonance imaging (MRI) — MRI is the best test for identifying masses in or ...

Treatment Options for Prolactinomas

Prolactinomas are typically treated with medication, specifically dopamine agonists, which mimic the effects of dopamine in the brain and help to reduce prolactin levels.

• Dopamine Agonists: These medications are usually the first line of treatment for prolactinomas. They include:
  • Bromocriptine (BEC)
  • Cabergoline
  • Quinagolide These drugs can effectively shrink tumor size and return prolactin levels to a healthy range [1, 5, 7].
• Preferred Medication: Cabergoline is often considered the preferred drug for treating prolactinomas due to its effectiveness and fewer side effects compared to bromocriptine [6].

Treatment Goals

The primary goal of medication treatment for prolactinomas is to:

• Reduce tumor size
• Normalize prolactin levels
• Prevent complications associated with high prolactin levels

Success Rates

Studies have shown that dopamine agonists are highly effective in treating prolactinomas, with success rates ranging from 80% to 90% [4].

References: [1] Context result 2: Aug 1, 2024 — Bromocriptine (BEC) is generally considered to be the agent of choice in the treatment of prolactinomas because of its long track record and ... [5] Context result 5: Drugs known as dopamine agonists are the first line medication in patients presenting with a prolactinoma. There are three available medications. All these ... [6] Context result 6: Cabergoline is the preferred drug for treating prolactinomas, because it is more effective than bromocriptine and has fewer side effects. [7] Context result 7: Medications called dopamine agonists are often very effective in shrinking prolactinoma tumors. They can also return your prolactin level to a healthy range.

Prolactinoma, a type of pituitary tumor that produces excess prolactin hormone, can be challenging to diagnose due to its similarity in symptoms with other conditions. Here are some differential diagnoses for prolactinoma:

• Acute Kidney Injury (AKI): While AKI is not directly related to prolactinoma, it's essential to rule out kidney problems that could mimic the symptoms of a prolactinoma.
• Erectile Dysfunction: This condition can be caused by various factors, including hormonal imbalances, which might be similar to those found in prolactinoma.
• Gigantism and Acromegaly: These conditions are also related to pituitary tumors, but they produce excess growth hormone rather than prolactin. However, the symptoms of these conditions can overlap with those of prolactinoma.
• Herpes Zoster: This viral infection can cause a range of symptoms, including pain and discomfort, which might be mistaken for those caused by a prolactinoma.
• Hypothyroidism: An underactive thyroid gland can lead to hormonal imbalances that might resemble those found in prolactinoma.

It's crucial to note that the most common clinical manifestations of prolactinoma are amenorrhea and infertility in women, and impotence, decreased libido, and infertility in men [4]. However, these symptoms can also be caused by other conditions, making differential diagnosis essential.

To confirm a diagnosis of prolactinoma, blood tests to measure prolactin levels and imaging tests such as CT or MRI scans are necessary. These tests can help rule out other potential causes of the symptoms and confirm the presence of a prolactin-producing tumor [8].

References:

[4] ORPHA:2965 [8] May 19, 2022 — 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 normal. [9] by CT AZ · Cited by 1 — A prolactinoma is a noncancerous (benign) pituitary tumor that produces a hormone called prolactin. This results in too much prolactin in the blood.