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    Endocrinology Prolactinoma

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    sharrisanyae
    This document discusses prolactinomas, a type of pituitary adenoma caused by abnormal prolactin-secreting cells. Prolactinomas are the most common type of functional pituitary tumor and usually present with high prolactin levels and symptoms like galactorrhea and amenorrhea. Females often present earlier than males due to menstrual irregularities. The case study describes a 35-year old female with headaches, vision problems, breast discharge, infertility, and an elevated prolactin level. MRI shows an enlarged pituitary gland, consistent with a prolactinoma. Prolactinomas are typically treated with dopamine agonists like bromocriptine or cabergoline to suppress prolactin secretion. Surgery may also be used.

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    Endocrinology Prolactinoma

    Uploaded by

    sharrisanyae
    40 views3 pages
    This document discusses prolactinomas, a type of pituitary adenoma caused by abnormal prolactin-secreting cells. Prolactinomas are the most common type of functional pituitary tumor and usually present with high prolactin levels and symptoms like galactorrhea and amenorrhea. Females often present earlier than males due to menstrual irregularities. The case study describes a 35-year old female with headaches, vision problems, breast discharge, infertility, and an elevated prolactin level. MRI shows an enlarged pituitary gland, consistent with a prolactinoma. Prolactinomas are typically treated with dopamine agonists like bromocriptine or cabergoline to suppress prolactin secretion. Surgery may also be used.

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    Endocrinology Prolactinoma

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    This document discusses prolactinomas, a type of pituitary adenoma caused by abnormal prolactin-secreting cells. Prolactinomas are the most common type of functional pituitary tumor and usually present with high prolactin levels and symptoms like galactorrhea and amenorrhea. Females often present earlier than males due to menstrual irregularities. The case study describes a 35-year old female with headaches, vision problems, breast discharge, infertility, and an elevated prolactin level. MRI shows an enlarged pituitary gland, consistent with a prolactinoma. Prolactinomas are typically treated with dopamine agonists like bromocriptine or cabergoline to suppress prolactin secretion. Surgery may also be used.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
    Download as odt, pdf, or txt
    40 views3 pages

    Endocrinology Prolactinoma

    Uploaded by

    sharrisanyae
    This document discusses prolactinomas, a type of pituitary adenoma caused by abnormal prolactin-secreting cells. Prolactinomas are the most common type of functional pituitary tumor and usually present with high prolactin levels and symptoms like galactorrhea and amenorrhea. Females often present earlier than males due to menstrual irregularities. The case study describes a 35-year old female with headaches, vision problems, breast discharge, infertility, and an elevated prolactin level. MRI shows an enlarged pituitary gland, consistent with a prolactinoma. Prolactinomas are typically treated with dopamine agonists like bromocriptine or cabergoline to suppress prolactin secretion. Surgery may also be used.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
    Download as odt, pdf, or txt
    of 3

    Internal Medicine

    Prolactinoma

    Introduction:
    Non-functional (chromophobic) adenomas are the most common pituitary tumors.
    Prolactinoma is a pituitary adenoma caused by abnormal proliferation of lactotrophs, it the most
    common type of functional pituitary adenoma.

    Abstract:
    Pituitary tumors (adenomas) can be secretory (prolactinoma,acromegaly, cushing’s) or non-secretory.
    The pituitary gland is aproximatley 600mg and is located in the Sella Tursica.The pituitary is
    comprised of anterior and posterior lobes.
    Most pituitary tumors are associated with high prolactin levels. High prolactin, galactorrhea and
    amenorrhea are common symptoms of pituitary tumors.
    Females usuallay presents with micro tumor because they have menstrual cycle as a “checker”, where
    missed/ irregular menstrual periods raise concern for which they seek medical help.
    However, males more often diagnosed much later and present with macro tumors because of later
    stage of detection.

    Case Study:
    A 35 year old AA female complains of frequent headaches, recent visual problems and slight breast
    discharge. She has not had her period for the past 9 months and is worried that despite of trying to
    conceive with husband she has not been able to do so for the past year and half. Past medical history
    reveals she is diabetic and has been suffering from recurring yeast infections.
    Lab results reveal a negative pregnancy test result, TSH level within normal range(0.5mU/I -5.0 mU/I),
    elevated prolactin levels. Magnetic resonance imagining of the head shows and enlarged structure
    sitting in the sella turcica.

    Discussion:
    Most pituitary tumors are asssociated with high prolactin levels. Symptoms come from hypersecretion
    of prolactin and its inhibitory effects. Prolactin cells (lactotrophs or mamatrophs) are located in the
    anterior pituitary.

    Some common symptoms of prolactinoma are:


    1.Women: Amenorrhea or Oligomenorrhea, secondary to GNRH inhibition by prolactin.
    Galactorrhea, Infertily, decressed libido, vaginal dryness/dyspareunia erectile dysfunction.
    2. Bone loss(osteoporosis)
    3.mood changes and depression
    4. headaches
    5.visual field defect.
    This patient presents with these classic symptoms.
    Growth of the pituitary lactrotrophs can put pressure on nearby structures. The Sella Tursica is
    adjacent to vascular structures such as: Carvenous sinous. Internal carotid artery, Cranial nerves,
    Optic chiasm.

    Investigation of hypersecretion or overporduction prolactin. Also evealuate mass effect. We can use
    the MRI. Micro adenoma<1cm, Macro adaenoma>1cm.
    A typical outter left quadrant of because the tumor is pressing on the optic chiasm.
    Serology:
    elevated prolactin
    decreased FSH, LH

    Treatment:
    Pharmacologic- Bromocriptine
    Cabergoline
    Dopamine agaonist. Dopamine functions to suppress prolactin release.

    Surgical: trans-sphenoidal surgery

    Conclusion:
    The quality of life is affected when too little of a hormone is being produced as well as when there is
    too much as well as when there is change. Hormonal replacement often falls short of the way nature
    intended. For example; cortisol (stress hormone).
    Reference
    1. Greenspan F, Gardner D. Basic & Clinical Endocrinology, 7th ed. New York: McGraw-Hill;
    2004.
    2. Ciccarelli A, Daly A, Beckers A. The epidemiology of prolactinomas. Pituitary. 2005;8(1):3-
    6.

    3. Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the
    diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). 2006;65(2):265-273.

    4. Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of


    hyperprolactinemia: an Endocrine Society Clinical Practice Guideline. J Clinical Endocrinol
    Metab. 2011;96(2):273-288.

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