Highlights & Basics
- Prolactinomas represent approximately 50% of all pituitary adenomas, with a female preponderance.
- Women usually present with amenorrhea and galactorrhea. Men may present with sexual dysfunction, hypogonadism, and sometimes gynecomastia, all related to the hyperprolactinemia.
- Premenopausal women present earlier due to menstrual irregularity and hence usually have microprolactinomas. Men and postmenopausal women often present later with macroadenomas, which may be invasive or giant tumors.
- Treatment with dopamine agonists usually results in prolactin normalization, symptom improvement, and tumor shrinkage.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Gadolinium-enhanced magnetic resonance imaging showing a left-sided 7 mm pituitary microprolactinoma
Gadolinium-enhanced magnetic resonance imaging showing a large pituitary macroadenoma in a 45-year-old man with hyperprolactinemia
Gadolinium-enhanced magnetic resonance imaging (coronal view) showing a 40 mm pituitary macroprolactinoma in a 41-year-old man before (A) and after (B) 2-month treatment with cabergoline
Gadolinium-enhanced magnetic resonance imaging (sagittal view) showing a 40 mm pituitary macroprolactinoma in a 41-year-old man before (A) and after (B) 2-month treatment with cabergoline
Citations
Wildemberg LE, Fialho C, Gadelha MR. Prolactinomas. Presse Med. 2021 Dec;50(4):104080.[Abstract][Full Text]
Melmed S, Casanueva FF, Hoffman AR, et al; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-88.[Abstract][Full Text]
Xia MY, Lou XH, Lin SJ, et al. Optimal timing of dopamine agonist withdrawal in patients with hyperprolactinemia: a systematic review and meta-analysis. Endocrine. 2018 Jan;59(1):50-61.[Abstract]
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