PROLACTINOMAS

• Most common functioning tumour is prolactinomas.
• Microadenomas- < 1cm in diameter (do not invade parasellar region)
• Macroadenomas- > 1cm in diameter (locally invade on adjacent structure)

 Clinical features- 

• Macroprolactinomas- 20: 1 (F : M)
• Macroadenomas-  1:1
• Values of PRL concentration >250 μg/L are associated with macroadenomas.
• Men present with loss of libido, infertility, signs of CNS compression, visual defects.
• Females with amenorrhea, infertility and galactorrhea.

Investigations-

1. MRI of ahead
2. Serum prolactin levels

• PRL < 100 μg/ L- microadenomas
• PRL >200 μg/ L- prolactinoma

Treatment- 

1. Asymptomatic microadenoma- no treatment required
2. Oral dopamine agonists (calcium bergoline and bromocriptine) are the line of treatment with micro or macroprolactinomas.
3. In pregnancy, bromocriptine taken

Surgery-

• Dopamine resistance
• Invasive macroadenomas

Don’t Forget to Solve all the previous Year Question asked on Prolactinomas