Pituitary prolactinoma

Pituitary prolactinoma is a very common pituitary disease. The incidence of this disease in women is much higher than that in men. It is generally caused by excessive secretion of lactone by the pituitary gland. If you have prolactinoma, there will be many symptoms, the most common of which are infertility, amenorrhea, and galactorrhea. Patients of different age groups and genders will show different symptoms.

Pituitary prolactinoma is very common in women. Such tumors do not threaten our lives. Generally, they can be cured by undergoing some surgical treatments when they grow up. Diet should be controlled well and light food should be mainly consumed. Let us learn more about this disease below.

Prolactinoma is a common hypothalamic-pituitary disease caused by excessive secretion of prolactin (PRL) by pituitary lactotrophic tumors. Typical clinical manifestations include amenorrhea, galactorrhea, infertility, hyperprolactinemia and pituitary space-occupying lesions. Symptomatic prolactinomas generally do not develop into macroadenomas. Some adenomas are invasive, with enlarged adenomas and elevated blood PRL. It ranks first in incidence among functional pituitary tumors. The incidence rate is higher in women than in men.

Clinical manifestations

The clinical symptoms of high PRL blood caused by prolactinoma vary depending on gender, age, duration of high PRL blood and tumor size. It is more common in women and often manifests as galactorrhea-amenorrhea syndrome. Tumor size was positively correlated with serum PRL concentration in patients.

1. PRL tumor in women

It occurs in young women aged 20 to 30 and is often a microadenoma. The typical clinical manifestations are the triad of amenorrhea, galactorrhea and infertility. The main symptoms in pre-pubertal women are delayed puberty, growth retardation and primary amenorrhea, and in post-pubertal women are shortened menstrual period, scanty or excessive menstrual flow, delayed menstruation, decreased or absent libido, loss of sexual desire, lack of orgasm, pain during intercourse, miscarriage, infertility, etc. Physical signs may include breast atrophy, pubic hair loss, vulvar atrophy, and decreased vaginal secretions.

2. Male PRL tumor

Prolactinomas in men are larger, tend to develop above the sella turcica, and are relatively rare. The main clinical manifestations are complete or partial sexual dysfunction, such as loss of libido, impotence, male breast development, male infertility, decreased sperm count, etc. Symptoms progress slowly and are not easily taken seriously. By the time of diagnosis, the disease is already in the late stage. Imaging examinations often show large adenomas with obvious nerve compression. Physical examinations reveal that adolescent patients may have stagnation of puberty, abnormal body shape, breast development and lactation, and small testicles, while adults may have sparse beards, breast development and lactation, sparse pubic hair, and soft testicles.

3. Tumor compression syndrome

Advanced PRL tumors and other types of pituitary adenomas, hypothalamic and parasellar tumors extend above the sella due to their huge tumor size, blocking PIF and causing hyperPRLemia. Common local compression symptoms are headache and visual abnormalities. The cause of the headache is increased intracranial pressure caused by the macroadenoma, accompanied by nausea and vomiting. The incidence of headache in male patients with PRL tumors is higher than that in female patients. Some microadenomas have small space-occupying lesions and may also cause headaches. The reason is still unclear.

4. Osteoporosis

Patients with PRL tumors and long-term high PRL blood levels sometimes present with osteoporosis as their first symptom. After treatment restores normal prolactin levels and gonadal function, bone density can improve but sometimes does not return to normal.

5. Acute pituitary stroke

If a fast-growing PRL tumor has intratumoral bleeding, acute pituitary stroke may occur, which is manifested by sudden severe headache, nausea, vomiting, decreased vision and other symptoms of cranial nerve compression, and even coma and exophthalmos, requiring emergency treatment. Patients may develop hypopituitarism after successful rescue.

If you are diagnosed with pituitary prolactinoma, you must actively seek treatment and do not worry too much. This disease is not like some other malignant tumors. It does not pose much threat to our life safety. Patients should be in a good mood, supplement the body with more nutrition, eat less spicy food, especially greasy food, and go to the hospital for regular check-ups.