Prolactinomas

Prolactinomas


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

Exam Important

Clinical features- 

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

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