Successful management of macroprolactinoma with aromatase inhibitor in a patient with hypogonadotropic hypogonadism

Öztürk, Feyza Yener; Sen, Esra Cil; Erol, Rumeysa Selvinaz; Çakır, Sezin Doğan; Basmaz, Seda Erem; Saygılı, Emre Sedar; Batman, Adnan

doi:10.1530/endoabs.49.ep836

Cited by 1 publication

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“…References from the manual search were all included in the electronic database searches. We reviewed 10 full-text papers for eligibility, and 6 studies published between 2002 and 2021 met the inclusion criteria and were included in the systematic review [ 17 , 18 , 19 , 20 , 21 , 22 ]. A summary of the trials included in the systematic review is shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…A summary of the trials included in the systematic review is shown in Table 1 . Of the included studies, five were case reports, each reporting on a single case [ 17 , 18 , 19 , 20 , 22 ], and one study was a case series reporting on four patients [ 21 ]. Anastrozole was the aromatase inhibitor used in four of the studies [ 18 , 19 , 21 , 22 ], while letrozole was used in two cases [ 17 , 20 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…As treatment with testosterone was the cause of the prolactin increase, it was decided to restart testosterone replacement therapy with 1 mg of anastrozole daily, along with cabergoline. This combination achieved normal prolactin and testosterone levels [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

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The Role of Aromatase Inhibitors in Male Prolactinoma

Akirov

Rudman

2023

JCM

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Background: dopamine agonists are the recommended treatment for male prolactinomas, but some patients may develop dopamine-agonist-resistant hyperprolactinemia, leading to persistent hypogonadism that requires treatment with testosterone. However, testosterone replacement therapy may be associated with a decrease in the efficacy of dopamine agonists due to the aromatization of testosterone to estradiol, which can stimulate the proliferation and hyperplasia of lactotroph cells in the pituitary, inducing resistance to dopamine agonists. Objective: this paper systematically reviewed the role of aromatase inhibitors for men with prolactinoma and dopamine-agonist-resistant or persistent hypogonadism following treatment. Method: we performed a systematic review of all studies (according to PRISMA guidelines), assessing the role of aromatase inhibitors, including anastrozole and letrozole, for male prolactinoma. An English-language search for relevant studies was conducted on PubMed from its inception to 1 December 2022. The reference lists of the relevant studies were also reviewed. Results: our systematic review identified six articles (nine patients), including five case reports and a single case series, on the use of aromatase inhibitors for male prolactinomas. Reducing estrogen levels with an aromatase inhibitor improved sensitivity to dopamine agonists, as the addition of anastrozole or letrozole improves the control of prolactin levels and may lead to the shrinkage of tumors. Conclusion: aromatase inhibitors are of potential value to patients with dopamine-agonist-resistant prolactinoma, or when hypogonadism persists while using high-dose dopamine agonists.

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