Prolactinoma
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Introduction
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Pathophysiology
Prolactinomas have a tendency to calcify. Increased prolactin levels (hyperprolactinemia) cause amenorrhea, galactorrhea, loss of libido, and infertility.
In males, hyperprolactinemia can lead to delayed or arrested puberty, infertility, impotence, or undervirilization.
Signs and Symptoms
- history
- physical exam
History
Symptoms of a prolactinoma includes
Amenomenorrhea/oligo
vagional dryness
reduced libido
erectile dysfunction
infertility
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
Microadinomas can be treated with DA agonists such as bromocriptine or cabergoline. This is a long term treatment.
Macroadenomas also respond well to DA agonists, but surgery can be necessary for mass effects.
Consequences and Course
Pregancy causes pituitary hyperplasia, and some prolactinomas are hormone responsive.
Resources and References
Topic Development
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