Prolactin Secreting Pituitary Adenomas

Correspondence to: Ioana Muntean, e-mail: [email protected] ABSTRACT. Hyperprolactinemia has different etiologic forms, among them, the prolactin-secreting pituitary tumors represent an important entity. In our study, were analyzed the clinical aspects, diagnostic procedures and therapeutical approach of 31 cases of prolactinomas (F/M ratio = 27/4) hospitalized in the Clinic of Endocrinology, County Hospital No. 1 Timisoara during the period 2000 2004. The study group was divided in two subgroups (by clinical, functional and imaging criteria): macroprolactinoma (13 cases; F/M = 9/4; age years = 36.69 ± 14.21); microprolactinoma (18 cases; F/M =18/0; age years = 31.55 ± 9.46). Prolactinomas represented 17.30% of cases from hypothalamic-pituitary pathology hospitalized in our clinic during the mentioned period. Anamnesis and clinical exam completed by hormonal assessment and imagistic investigations (CT/MRI) are essential for an accurate diagnosis. All the cases caused by the effects of hyperprolactinemia on hypotalamic-pituitary-gonadal axis and 5 patients with macroprolactinoma (F/M ratio = 2/3) presented tumor mass effect. The plasma prolactin levels were significantly higher (p < 0.00001) in patients with macroprolactinoma comparing with microprolactinoma cases. All the patients were treated with dopamine agonist drugs with very good response regarding the decrease of prolactin levels and tumor shrinkage (only one case didn’t show a normal prolactin level despite long term medical therapy associated with tumor disappearance, and despite the chang of dopamine agonist form). Four women with macroprolactinoma became pregnant after one year of treatment with bromocriptine and all of them reached the parturition without any event (continuing during the pregnancy the therapy with bromocriptine).