1887
Volume 2008, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

Objectives: To describe the clinical features of prolactin-producing pituitary adenoma (prolactinoma) in adult patients.

Methods: In a prospective hospital-based study, adult patients with prolactinoma presenting to the National Center for Neurological diseases and the National Center for cancer in Khartoum, Sudan were enrolled in the period from January 2001 to February 2005. The diagnosis was based on finding a pituitary adenoma on cranial MRI and an associated elevated blood prolactin level above 200 pig/L. The size of the adenoma was classified as either microadenoma ( < 10 mm without sellar enlargement or extrasellar extension) ormacroadema (>10 mm). The hormone profile done on each patient included blood level of prolactinand other pituitary trophic hormones, free triiodothyronine and free thyroxine hormones.

Results: Sixteen (14 females and 2 males) were identified as having a prolactinoma. The female to male ratio was 7:1. Their mean age was 24 ± 5.1 years. The prolactinoma was macroadenoma in 9 cases and microademoma in 7. Galactorrhea, amenorrhea and infertility (primary or secondary) were the commonest presenting symptom followed by headache. Affection of the visual pathway, either as bitemporal hemianopia (41.2%) or optic atrophy (11.8%), was the major neurological deficit. The mean prolactin level in macroadenoma was 2053 ± 442.6 jig/L and in microadenoma was 853.6 ± 77.8 jig/L.

Conclusions: Our prolactinoma patients, when reaching the appropriate medical attention, are more likely having an expanded macroadeoma that is compromising the visual pathway. Early recognition and referral to specialized clinics is necessary and that should have a favorable prognostic implication.

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2008-12-01
2019-10-22
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References

  1. 1. Surawics   TS., , McCarthy   BJ., , Kupelian   V., , Jukich   PJ., , Bruner   JM., , Davis   FG. . Descriptive epidemiology of primary brain and CNS tumors: result from the central brain tumor registry of the United States. 1995–1999. . Neuro-oncol . 1999; ;1: : 14– 25 .
    [Google Scholar]
  2. 2. Russell   EJ., , Molitch   ME. . The pituitary «incidentaloma». . Ann Intern Med . 1990; ;112: : 925– 931 .
    [Google Scholar]
  3. 3. Zargar   AH., , Laway   BA., , Masoodi   SR., , Salahuddin   M., , Ganie   MA., , Bhat   MH., , Wani   Al., , Bashir   MI. . Clinical and endocrinological aspects of pituitary tumors. . Saudi Med J . 2004; ;25: : 1428– 1432 .
    [Google Scholar]
  4. 4. Ciccarelli   A., , Daly   AF., , Beckers   A. . The epidemiology of prolactinoma. . Pituitar . 2005; ;8: : 3– 6 .
    [Google Scholar]
  5. 5. Daly   AF., , Rixhon   M., , Adam   C., , Dempegioti   A., , Tichomirowa   MA., , Beckers   A. . High prevalence of pituitary adenomas: A cross sectional study in province of Liege, Belgium. . J Clin Endonol Metab . 2006; ;91: : 4769– 4775 .
    [Google Scholar]
  6. 6. Casanueva   FF., , Molitch   ME., , Schlechte   JA., , Abs   R., , Bonert   V., , Bronstein   MD., , Brue   T., , Cappabianca   P., , Colao   A., , Fahlbusch   R., , Fideleff   H., , Hadani   M., , Kelly   P., , Kleinberg   D., , Laws   E., , Marek   J., , Scanlon   M., , Sobrinho   LG., , Wass   JA., , Giustina   A. . Guidelines of the pituitary society for the diagnosis and management of prolactinomas. . Clin Endocrinol (Oxf) . 2006; ;65: : 265 .
    [Google Scholar]
  7. 7. Molitche   ME. . Medical management of prolactin-secreting pituitary adenoma. . Pituitary . 2002; ;5: : 55– 65 .
    [Google Scholar]
  8. 8. Colao   A., , Di Sarno   A., , Landi   ML., , Cirillo   S., , Sarnacchiaro   F., , Faciolli   G., , Pivonello   R., , Cataldi   M., , Merola   B., , Annunziato   L., , Lombardi   G. . Long-term and low-dose treatment with cabergoline induced macroprolactinoma shrinkage. . J Clin Endocrinol Metab . 1997; ;82: : 3574– 3579 .
    [Google Scholar]
  9. 9. Orrego   JJ., , Chandler   WF., , Barkan   AL. . Pergolide as a primary therapy for macroprolactinoma. . Pituitary . 2000; ;3: : 251– 256 .
    [Google Scholar]
  10. 10. Aron   DC., , Tyrrel   JB., , Wilson   CB. . Pituitary tumors: Current concepts in diagnosis and management. . West J Med . 1995; ;162: : 340– 352 .
    [Google Scholar]
  11. 11. Asano   S., , Ueki   K., , Suzuki   I., , Kirino   T. . Clinical features and medical treatment of male prolactinomas. . Acta Neurochir (Wien) . 2001; ;143: : 465– 470 .
    [Google Scholar]
  12. 12. Nishioka   H., , Ito   H., , Haraoka   J., , Hirano   A. . Growth potential of female prolactinoma. . Surg Neurol . 2001; ;55: : 213– 217 .
    [Google Scholar]
  13. 13. Ma   W., , Ikeda   H., , Yoshimoto   T. . Clinicopathologic study of 123 cases of prolactin-producing pituitary adenomas with special reference to multihormone production and clonality of the adenomas. . Cancer . 2002; ;95: : 258– 266 .
    [Google Scholar]
  14. 14. Randall   RV., , Scheithauer   BW., , Laws   ER Jr., , Abbound   CF., , Ebersold   MJ., , Kao   PC. . Pituitar adenomas associated with hyperprolactinemia: a clinical and immunohistochemical study of 97 patients operated transsphenoidally. . Mayo Clin Proc . 1985; ;60: : 753– 762 .
    [Google Scholar]
  15. 15. De Rosa   M., , Ciccarelli   A., , Zarrilli   S., , Guerra   E., , Gaccione   M., , Di Sarno   A., , Lombardi   G., , Colao   A. . The treatment for 24 months normalizes the quality of seminal fluid in hyperprolactinaemic males. . Clin Endocrinol (Oxf) . 2006; ;64: : 307– 313 .
    [Google Scholar]
  16. 16. Ciccarelli   A., , Guerra   E., , De Rosa   M., , Milone   F., , Zarrilli   S., , Lombardi   G., , Colao   A. . PRL-secreting adenomas in male patients. . Pituitary . 2005; ;8: 1 : 39– 42 .
    [Google Scholar]
  17. 17. De Rosa   M., , Colao   A., , Di Sarno   A., , Ferone   D., , Landi   ML., , Zarrilli   S., , Paesano   L., , Merola   B., , Lombardi   G. . Cabergoline rapidly improves gonadal function in hyperprolactinemic males: A comparison with bromocriptine. . Eur J Endocrinol . 1998; ;138: : 286– 293 .
    [Google Scholar]
  18. 18. Feigenbaum   SL., , Downey   DE., , Wilson   CB., , Jaffe   RB. . Transsphenoidal pituitary resection for preoperative diagnosis of prolactin-secreting pituitary adenoma in women: long term follow-up. . J Clin Endocrinol Metab . 1996; ;81: : 1711– 1719 .
    [Google Scholar]
  19. 19. Wolfsberger   S., , Czech   T., , Vierhapper   H., , Benavente   R., , Knosp   E. . Microprolactinomas in males treated by transphenoidal surgery. . Acta Neurochir (Wein) . 2003; ;145: : 935– 940 .
    [Google Scholar]
  20. 20. Tsagarakis   S., , Grossman   A., , Plowman   PN., , Jones   AE., , Touzel   R., , Rees   LH., , Wass   JA., , Besser   GM. . Megavoltage pituitary irradiation in the management of prolactinomas: long-tem follow-up. . Clin Endocrinol (Oxf) . 1991; ;34: : 399– 406 .
    [Google Scholar]
  21. 21. Littley   MD., , Shalet   SM., , Reid   H., , Beardwell   CG., , Sutton   ML. . The effect of external pituitary irradiation on elevated serum prolactin levels in patients with pituitary macroadenoma. . QJ Med . 1991; ;81: : 985– 998 .
    [Google Scholar]
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