Sex
Laboratory studies include the following:
Management
Frequency: International
Frequency: United States
1) Serum prolactin (PRL) 2) Serum pregnancy test 3) Serum thyroid-stimulating hormone (TSH) 4) Serum testosterone or bioavailable testosterone: In males presenting with symptoms of hypogonadism 5) Basal and cosyntropin-stimulated cortisol: In patients with a history suggestive of adrenal insufficiency 6) Serum insulinlike growth factor-1: In persons with features consistent with acromegaly
Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. This may partially be due to the fact that the male patients often present much later (for clinical evaluation of hypogonadism) than do the female patients (for clinical evaluation of amenorrhea).
The exact frequency with which prolactinomas occur in the general population is not clearly established. In nonselected surgical series, this tumor accounts for approximately 25-30% of all pituitary adenomas. Some growth hormone (GH) – producing tumors also cosecrete PRL. Microprolactinomas are much more common than macroprolactinomas.
In a study of 81,449 inhabitants of Banbury, Oxfordshire, in the United Kingdom, Fernandez et al determined the incidence of pituitary adenomas there to be 77.6 cases per 100,000 population, with the majority of cases (57%, or 44.4 persons per 100,000 population) being prolactinomas.
Treatment is indicated if mass effects from the tumor and/or significant effects from hyperprolactinemia are present. Bromocriptine (BEC) is generally considered to be the agent of choice in the treatment of prolactinoma because of its long track record and safety. As a dopamine (DA) agonist, it decreases the synthesis and secretion of PRL. It also decreases the rate of tumor cell division and the growth of individual cells.
