Diagnosis and Drug Therapy of Prolactinoma

  title={Diagnosis and Drug Therapy of Prolactinoma},
  author={Enrica Ciccarelli and Franco Camanni},
SummaryA prolactin-secreting pituitary tumour is the most frequent cause of hyperprolactinaemia that commonly occurs in clinical practice. Prolactinomas occur more frequently in women than in men and may differ in size, invasive growth and secretory activity. At presentation, macroadenomas are more frequently diagnosed in men. Specific immunohistochemical stains are necessary to prove the presence of prolactin in the tumour cells. The main investigations in the diagnosis of a prolactin… 

Pituitary Disorders

In patients with Cus(≥10mm).

Managing prolactinoma during pregnancy

Objective: Prolactinomas are the most common pituitary tumors in pregnant women. We conducted this study on pregnant women with prolactinoma to determine their clinical symptoms and signs and

Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors

The impressive improvement of neurosurgical endoscopic techniques allows a far better definition of the tumoral tissue during surgery and the remission of endocrine symptoms in many patients with pituitary tumors, changing the therapeutic strategy in prolactinomas.

Managing Prolactinoma during Pregnancy Prolactinoma during Pregnancy Prolactinoma during Pregnancy Prolactinoma during Pregnancy

Macroprolactinomas are more likely to enlarge during pregnancy than microprolActinomas, and conservative management was successfully done in all patients without surgery or medical therapy.

Clinical management and outcome of 36 invasive prolactinomas treated with dopamine agonist

Patients who achieve TVR >25% with NP with 3 months of bromocriptine administration had a high possibility of showing good long-term response (TVR >50% withNP) to bromoriptine, and a higher dose of dopamine agonist (DA) or other DA should be considered for patients who achieveTVR <25% without NP.

Clinical Outcome of Invasive Pituitary Prolactinomas Treated with Cabergoline

Patients who achieve TVRˁ25%with NP with 3 months of cabergoline administration had a high possibility of showing good long term response (TVR˃50% with NP) to cabergol, and a higher dose of dopamine agonist (DA) should be considered for patients who achieve televisionR˂25% without NP.

Chapter 29 Multimodality Treatment of Pituitary Adenomas

The mortality in untreated acromegaly is two to three times higher than that of the general population, but with appropriate reduction of GH hypersecretion, it normalizes.

Pregnancy and pituitary disorders.

The changes in anatomy and physiology of the pituitary gland during pregnancy are reviewed and Pituitary disorders namely Cushing's disease; acromegaly; prolactinoma; TSH-secreting, gonadotropin-producing, and clinically nonfunctioning adenomas; craniopharyngioma; and Sheehan's syndrome in relation to pregnancy are discussed.

Efficacy of cabergoline on rapid escalation of dose in men with macroprolactinomas.

The preliminary findings show that rapid build-up of cabergoline doses increases its efficacy as well as rapidity of response in terms clinical improvement, normalization of serum prolactin and gonadal functions and reduction in tumour size, without compromising its safety in men with macroprolactinomas.

Rapidly progressing giant invasive prolactinoma

To the authors' knowledge, this is the first report of giant prolactinoma presenting with symptoms of sinusitis and nasopharyngeal tumour.



Giant invasive prolactinoma: a case report and review of nine further cases.

In vitro studies of tissue from a patient with an exceptionally aggressive tumour which extended outside the skull and emerged within the internal jugular vein showed that although prolactin secretion was reduced by both bromocriptine and dopamine, neither agent affected cytoplasmic levels of Prolactin mRNA, suggesting relative autonomy of prolACTin synthesis.

Clinical and pathological effects of bromocriptine on prolactin-secreting and other pituitary tumors.

There is insufficient evidence to recommend this drug as primary therapy for either prolactin-secreting or nonfunctional macroadenomas, but the drug may have potential as a preoperative adjunct to effect shrinkage of prolACTinomas and theoretically, at least, make excision easier and possibly more complete.

Pergolide for the treatment of pituitary tumors secreting prolactin or growth hormone.

It is concluded that pergolide reduces hypersecretion and shrinks most prolactin-secreting macroadenomas and in some patients long-term pergOLide therapy may be superior to surgery and x-ray treatment.

Presence of Human Prolactin-Producing Adenomas and Bromocriptine: A Histological, Immunocytochemical, Ultrastructural, and Morphometric Study

All four bromocriptine- treated patients demonstrated a reduction in serum PRL levels and tumor size on computed tomography, and patients 5 and 6 showed reexpansion of their tumors after drug withdrawal.

Resistance to bromocriptine in prolactinomas.

There was a very good correlation between the density of dopaminergic binding sites and maximal inhibition of adenylate cyclase activity in bromocriptine-responsive prolactinoma patients and resistant patients who had no tumor growth during therapy.

Necrotic changes in prolactinomas after long term administration of bromocriptine.

Long term bromocriptine treatment of patients with prolactinomas may result in necrosis of some adenoma cells in some patients.


A 28 year old man presented with partial hypopituitarism and signs of a pituitary tumour and died 12 years after the initial diagnosis, appearing to be the third well documented case of a metastasizing, prolactin secreting pituitARY tumour.

Prolactin-secreting pituitary tumors in amenorrheic women: a comprehensive study.

The refinement of the transsphenoidal surgical approach to exploration of the sella turcica and the knowledge that amenorrheagalactorrhea and infertility can be reversed by selective surgical excision of a pituitary tumor has created a spectrum of patients now recognized as having hyperprolactinemia and PRL-secreting tumors.

Pituitary tumors secreting growth hormone and prolactin.

The recent advances in molecular biology, radioimmunoassay, neuroradiology, and transsphenoidal microneurosurgery techniques have greatly improved the understanding of the pathophysiology of these tumors, enhanced diagnostic accuracy, and led to newer medical and surgical therapeutic approaches.

Histological classification of pituitary disease.

  • S. AsaK. Kovacs
  • Medicine, Biology
    Clinics in endocrinology and metabolism
  • 1983