Prolaktinome

Prolaktinome, also known as prolactinoma, is a benign pituitary tumor that produces excessive amounts of the hormone prolactin. It is the most common type of functioning pituitary adenoma, accounting for approximately 40% of all pituitary tumors. Prolactin is responsible for stimulating breast milk production and plays a role in reproductive functions.

The clinical presentation of prolaktinome varies based on hormone levels and tumor size. In women, symptoms typically include amenorrhea, galactorrhea (unexpected breast milk production), infertility, and decreased libido. Men may experience erectile dysfunction, decreased libido, gynecomastia (breast enlargement), and visual disturbances if the tumor compresses adjacent structures.

Diagnosis involves measuring serum prolactin levels, which are invariably elevated in prolaktinomas. Imaging studies, primarily magnetic resonance imaging (MRI), help to visualize the size and extent of the tumor. Differential diagnosis includes other causes of hyperprolactinemia, such as medications, hypothyroidism, and stalk effect from larger pituitary tumors.

Treatment options primarily include pharmacotherapy with dopamine agonists such as cabergoline or bromocriptine, which effectively reduce prolactin levels and often decrease tumor size. Surgical removal of the tumor via transsphenoidal resection is considered if medication is ineffective or contraindicated. Radiation therapy is rarely used.

Prolaktinome generally has a favorable prognosis when diagnosed early and managed appropriately. Monitoring involves regular measurement of prolactin levels and imaging to assess tumor response. Overall, with proper treatment, most patients can experience symptom resolution and normalization of prolactin levels.