What are the other Names for this Condition? (Also known as/Synonyms)

• Prolactin-Secreting Adenoma of the Pituitary

What is Prolactinoma? (Definition/Background Information)

• Prolactinoma is a benign tumor of the pituitary gland in the brain
• The pituitary gland is situated at the base of the brain and plays a major role in the growth, development, metabolism, and reproduction of human beings
• Prolactin is a hormone that activates lactation, a process whereby the breasts enlarge and start producing milk for the baby. In Prolactinoma, there is excess production of prolactin hormone by the pituitary gland
• The common signs and symptoms associated with Prolactinoma include infertility, amenorrhea, and galactorrhea (whitish discharge from the nipples)
• Prolactinoma is generally treated using medications or a surgery. The prognosis of Prolactinoma is usually good with appropriate treatment

Who gets Prolactinoma? (Age and Sex Distribution)

• Individuals under the age of 40 years are most commonly affected by Prolactinoma
• It occurs more commonly in women than in men
  • Prolactinomas that are smaller in size, called microprolactinoma, are more common in women
  • Prolactinoma that are larger in size, called macrolactinoma, are commonly found in men
• Though it is a rare tumor, it can occur worldwide. All races and ethnic groups may be affected

What are the Risk Factors for Prolactinoma? (Predisposing Factors)

No clear-cut risk factors for Prolactinoma have been established to date. However, the following factors may be involved:

• Age: Individuals between the ages of 20-50 years are more likely to be affected
• Females have a higher incidence than males for Prolactinoma

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Prolactinoma? (Etiology)

The pituitary gland produces many different types of hormones such as prolactin, growth hormone, thyroid stimulating hormone, etc.

• Prolactinoma is a benign tumor of the pituitary gland located in the brain. It results in the excess production of prolactin hormone by the gland
• Some of the cells in the pituitary gland producing prolactin, multiply at a faster rate than normal, resulting in Prolactinoma
• There may be some inherited or genetic factors for the formation of Prolactinoma. However, the exact gene associated with this abnormality has not been discovered yet

What are the Signs and Symptoms of Prolactinoma?

The signs and symptoms associated with Prolactinoma may be different for children and adults (and whether the individual is a male or a female). The signs and symptoms include:

In females:

• Signs and symptoms depend on the size of the tumor
• They are usually slow-growing and form a single mass
• Amenorrhea: Complete absence of menstrual periods
• Galactorrhea: Milky discharge from both nipples, even though the woman is not pregnant or breastfeeding
• Infertility: The biological inability of a woman to become pregnant

In males:

• Erectile dysfunction or impotency: It is a medical abnormality when the male cannot develop or sustain an erection (firmness of the penis) needed for sexual activities
• Gynecomastia: Unusually enlarged breasts in men

In children:

• Reduced growth
• Delayed puberty

These signs and symptoms are common to both men and women:

• Low bone density and thickness
• A lack of interest in sexual activities
• Headaches
• Vision abnormalities: Double vision and decreased peripheral vision

How is Prolactinoma Diagnosed?

The diagnosis of Prolactinoma may involve the following tools:

• Complete evaluation of medical history along with a thorough physical exam
• Blood tests are performed to check for:
  • Prolactin levels in blood
  • Levels of other hormones produced by the pituitary gland
• Pregnancy test is done for women of childbearing age
• Imaging tests: Magnetic Resonance imaging test of the brain may reveal an increased size of the pituitary gland
• Vision tests are conducted to see if the tumor in the pituitary gland has affected one’s vision

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Prolactinoma?

Prolactinoma can lead to the following complications such as:

• Vision impairment: When Prolactinoma is left untreated, it may lead to compression of the optic nerve resulting in vision deterioration
• Hypopituitarism: When the tumor is large in size, more pressure is exerted on the pituitary gland resulting in underproduction of the other hormones (normally produced by the gland) leading to:
  • Hypothyroidism - decreased functioning of the thyroid gland
  • Adrenal insufficiency - decreased functioning of the adrenal gland
  • Growth hormone deficiency
• Osteoporosis leading to decreased bone density and loss of bone mass
• Recurrence of the tumor after surgery

How is Prolactinoma Treated?

The treatment options for Prolactinoma include:

• Small Prolactinomas are treated medically using medications such as dopamine agonist medicines, including bromocriptine and cabergoline
• Larger prolactinomas and prolactinomas not responding to medical treatment require surgical removal of the tumor
• Follow-up checkups are important following treatment
• Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals

How can Prolactinoma be Prevented?

• Current medical research has not established a way of preventing Prolactinoma formation
• Regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations for those who have already endured the tumor are helpful

What is the Prognosis of Prolactinoma? (Outcomes/Resolutions)

• The prognosis of Prolactinoma is generally good with proper and effective treatment
• If the tumor is surgically removed, then the most reliable prognostic factor of Prolactinoma is dependent on whether the tumor can be completely removed with free margins (no traces of the tumor in adjoining tissue) or not
• As with any tumor, it is important to have follow-up appointments with a physician to monitor for any returning tumors

Additional and Relevant Useful Information for Prolactinoma:

Research work is being carried out to find the gene that is involved in the development of pituitary tumors.