Update on prolactinomas. Part 2: Treatment and management strategies

Wong, Anthony; Eloy, Jean Anderson; Couldwell, William T.; Liu, James K.

doi:10.1016/j.jocn.2015.03.059

Cited by 79 publications

(69 citation statements)

References 71 publications

(205 reference statements)

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“…Dopamine agonists, which lead to tumor cell apoptosis and secondary necrosis, are the first line of treatment for prolactinomas (15,31,32). However, bromocriptine should be administered for ≥3 months for other types of pituitary adenomas in order to rule out prolactinoma (6).…”

Section: Discussionmentioning

confidence: 99%

Role of prolactin/adenoma maximum diameter and prolactin/adenoma volume in the differential diagnosis of prolactinomas and other types of pituitary adenomas

et al. 2017

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Abstract. The present study aimed to investigate the function of the prolactin/adenoma maximum diameter (PRL/MD) and the prolactin/adenoma volume (PRL/V) in the differential diagnosis of prolactinomas and other types of pituitary adenomas. A total of 118 patients with pituitary adenoma, hyperprolactinemia and a plasma PRL <250 µg/l were enrolled. Clinical data from these patients were retrospectively analyzed. A receiver operating characteristic curve was plotted. The function of PRL, PRL/MD and PRL/V in the differential diagnosis of prolactinomas and other types of pituitary adenomas was compared. The results revealed that a PRL of 55.65 µg/l was the most accurate [sensitivity (SE), 0.800; specificity (SP), 0.716; positive predictive value (PPV), 0.857; negative predictive value (NPV), 0.933; and Youden index (YI), 0.516]. The PRL/MD with the highest diagnostic value was 4.03 µg/(l x mm) (SE, 0.800; SP, 0.898; PPV, 0.727; NVP, 0.929; and YI, 0.698). The PRL/V with the highest diagnostic value was 54.00 µg/(l x cm 3 ) (SE, 0.900; SP, 0.966; PPV, 0.900; NVP, 0.966; and YI, 0.866). The PRL/MD tended to be of higher diagnostic accuracy than PRL, but this difference was not statistically significant (P= 0.097). The differentiation ability of PRL/V was significantly stronger than that of PRL (P=0.028). Thus, serum PRL, PRL/MD and PRL/V levels may be able to differentiate prolactinomas from other types of hyperprolactinemia-causing pituitary adenomas prior to treatment. PRL/V may be better than the PRL level in achieving a differential diagnosis, and the optimal PRL/V ratio for differentiating prolactinomas from other types of hyperprolactinemia-causing pituitary adenomas was 54.00 µg/(l x cm 3 ).

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Section: Discussionmentioning

confidence: 99%

Role of prolactin/adenoma maximum diameter and prolactin/adenoma volume in the differential diagnosis of prolactinomas and other types of pituitary adenomas

et al. 2017

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“…Studies on bone loss have generally focused on postmenopausal women or hyperparathyroidism [6]. However, long term hypogonadism may also lead to reduced bone mineral density due to the inhibitory effect of prolactin on sex steroids [7]. This hypothesis is supported by a study that shows that when testosterone levels are restored to within normal limits, irrespective of prolactin levels, there is improvement in bone mineral density [8].…”

Section: Discussionmentioning

confidence: 99%

“…The goals of treatment for this patient, are to normalize prolactin levels and ameliorate its clinical consequences, allowing restoration of sexual dysfunction and reduce tumor size to relieve visual defect. Pharmacological therapy with dopamine agonists (bromocriptine and cabergoline) is the first line of treatment for prolactinomas due to its effectiveness in normalizing prolactin levels [7]. Dopamine agonist therapy has also shown marked reductions in tumor size via mechanisms that are not yet fully understood.…”

Section: Discussionmentioning

confidence: 99%

Prolactinoma with galactorrhea and dysfunction erectile in man, a case report

Hendarto¹

2017

Proceedings of the 1st International Integrative Conference on Health, Life and Social Sciences (ICHLaS 2017)

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Abstract-Prolactinoma, is the most common type of pituitary adenoma. Signs and symptoms are due to either the effect of excess hormone secretion or local compression. Here we report a male patient with prolactinoma presented with high prolactin level, severe headache, diffuse arthralgias, visual field impairment, erectile dysfunction, and galactorrhea. A 40-yearold married man was admitted to the hospital with severe headache, diffuse arthralgias, bitemporal hemianopsia, galactorrhoea, and erectile dysfunction. The pubic and axillary hairs appeared normal and the development of the external genital organs seemed normal. Endocrinological studies revealed hyperprolactinemia. The serum testosterone was low, while the thyroid hormone, growth hormone, and cortisol hormone levels were normal. An X-ray of his L spine was concerning for decreased bone mass. CT scan Pituitary with contrast showed a large macroprolactinoma mass. The diagnosis of prolactinoma was made, and because the patient has progressive vision loss, combination therapy of surgery, typically a transphenoidal resection of the tumor and medication with cabergoline 0.5 mg twice weekly, was suggested. Prolactinoma in patients can cause clinical symptoms as a result of mass effects and/or hyperprolactinaemia. Careful history and physical examinations should reveal the diagnosis.

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“…По данным литературы, микроаденомы менее резистентны к агонистам дофамина, чем макроаденомы. 10 % случаев микроаденом и 18 % случаев макроаденом не отвечают нормализацией уровня пролактина в ответ на прием каберголина [14]. Резистентность у мужчин выше, чем у женщин.…”

Section: терапевтические подходы в лечении пролактином медикаментозноunclassified

Prolactinoma: Etiological, Diagnostic and Therapeutic Aspects

Ворожцова¹,

Pavlenko²,

Lukyanenok³

et al. 2016

СПНО (MPSE)

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Повышение уровня пролактина в крови, как показывают исследования, может вести к задержке пубертата, дисменорее и аменорее, в связи с чем является одним из звеньев патологической цепи, играющей важную роль при беременности, в ряде случаев способствуя появлению проблем с зачатием, ведущим к невынашиванию беременности, нарушению фертильности. Описывается важность своевременного выявления гиперпролактинемии, указывается на возможную связь с артериальной гипертензией и избыточной массой тела, снижением гонадотропной функции у мужчин. Обзор литературы посвящен наиболее актуальным клиническим, диагностическим и терапевтическим аспектам пролактиномы гипофиза. Проведен анализ современных рандомизированных российских и зарубежных исследований, в которых показаны более перспективные подходы и методы лечения у больных с различными видами пролактином. Выявлены актуальные причины развития пролактином гипофиза, а также более точные диагностические критерии данного заболевания. Показаны современные рациональные подходы как медикаментозной, так и хирургической терапии для рецидивирующих и резистентных пролактином гипофиза. Ключевые слова: пролактинома, гиперпролактинемия, макропролактин, диагностика, агонисты дофаминовых рецепторов, хирургическое лечение, резистентные пролактиномы. Sciences, Tomsk, е-mail:Natula-2014@yandex.ru Increased prolactin in the blood studies may lead to a delay of puberty, amenorrhea and dysmenorrhea, and therefore be part of the pathological chain that plays an important role in pregnancy, in some cases, contributing to the emergence of problems with conceiving, leading to childbearing, fertility. Describes the importance of timely detecting hyperprolactinemia, indicated a possible link with arterial hypertension and overweight, lower gonadotrophic function in men.The review of literature is devoted to the most actual clinical, diagnostic and therapeutic aspects of a prolactinoma of hypophysis. The analysis of the modern randomized Russian and foreign researches in which more perspective approaches and methods of treatment at patients with different types with protactinium are shown is carried out. The actual reasons of development by hypophysis protactinium, and also more precise diagnostic criteria of this disease are established. The modern rational approaches are shown to both medicaments', and surgical therapy for relapsing and refractory by hypophysis prolactinoma. PROLACTINOMA: ETIOLOGICAL, DIAGNOSTIC AND THERAPEUTIC ASPECTS

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Update on prolactinomas. Part 2: Treatment and management strategies

Cited by 79 publications

References 71 publications

Role of prolactin/adenoma maximum diameter and prolactin/adenoma volume in the differential diagnosis of prolactinomas and other types of pituitary adenomas

Role of prolactin/adenoma maximum diameter and prolactin/adenoma volume in the differential diagnosis of prolactinomas and other types of pituitary adenomas

Prolactinoma with galactorrhea and dysfunction erectile in man, a case report

Prolactinoma: Etiological, Diagnostic and Therapeutic Aspects

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