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- Title
Prolactinoma -- possible change in treatment approach? -- review of the literature.
- Authors
Dąbrowska, Anna; Paduszyńska, Natalia; Gonciarz, Marta; Zaliwska, Dominika; Czach, Magdalena; Strojny, Agnieszka; Adamiec, Dominika; Kraszkiewicz, Adrianna; Kamińska, Monika; Do, Monika K.
- Abstract
A recent Pituitary Society consensus statement provided clinical recommendations for diagnosing and managing prolactin-secreting pituitary adenomas, known as prolactinomas. Prolactinomas are rare, usually benign tumours of the anterior pituitary gland that result in excessive prolactin production, or hyperprolactinemia. Despite being non-life- -threatening, patients often prompt medical attention due to symptoms stemming from elevated prolactin levels, such as reproductive and sexual dysfunction, e.g. menstrual irregularities, galactorrhoea, infertility, or from mass effects like headaches, cranial nerve palsies, and vision problems. Laboratory testing showing hyperprolactinemia and low sex hormone levels is used for diagnosis. Unlike other pituitary tumours, the primary treatment for prolactinomas is typically pharmacological therapy with dopamine agonists. However, for patients with smaller tumours (microprolactinomas) or well-circumscribed larger tumours (macroprolactinomas), surgery may be considered the first-line option. It is a surprising shift in the therapeutic strategy. For patients resistant to dopamine agonists, alternative strategies include switching medications, increasing dosages, or pursuing neurosurgery or radiotherapy. The key treatment goals are to normalize prolactin levels, restore reproductive and sexual function, and reduce tumour size. This review aimed to provide clinicians with an up-to-date overview of diagnostics and treatment options for patients with prolactin- -secreting pituitary adenomas, as well as highlight the potential diagnostic challenges and complexity of treatment.
- Subjects
ANTERIOR pituitary gland; PITUITARY tumors; BENIGN tumors; LITERATURE reviews; PROLACTINOMA; DOPAMINE agonists
- Publication
Family Medicine Forum / Forum Medycyny Rodzinnej, 2024, Vol 18, Issue 4, p134
- ISSN
1897-3590
- Publication type
Article