Prolactinoma
Prolactinoma is a condition in which a
noncancerous tumor (adenoma) in the pituitary gland in your brain
overproduces the hormone prolactin. The major effect of increased
prolactin is a decrease in normal levels of sex hormones — estrogen in
women and testosterone in men.
Although prolactinoma isn't
life-threatening, it can cause vision impairment, infertility and other
effects. Prolactinoma is one of several types of tumors that can develop
in your pituitary gland. Some pituitary tumors may produce hormones in
excess (functioning pituitary tumors), but most don't (nonfunctioning
pituitary tumors).
The pituitary gland is a small
bean-shaped gland located at the base of your brain. Despite its small
size, the pituitary gland influences nearly every part of your body. Its
hormones help regulate important functions such as growth, blood
pressure and reproduction.
Doctors often are able to effectively
treat prolactinoma with medications to restore your prolactin level to
normal. Surgery to remove the pituitary tumor also may be an option.
Treatment
Specific goals in the treatment of prolactinoma include:
-
Returning the
production of prolactin to normal levels
-
Restoring normal
pituitary gland function
-
Reducing the size
of the pituitary tumor
-
Eliminating any
signs or symptoms from tumor pressure, such as headaches or vision
problems
Treatment for prolactinoma consists of two main therapies:
Medications
Oral medications often can decrease the production of prolactin and
eliminate symptoms. Medications may also shrink the tumor. However,
long-term treatment with medications is necessary.
Doctors use drugs known as dopamine agonists to treat prolactinoma.
These drugs mimic the effects of dopamine — the brain chemical that
normally controls prolactin production — but are much more potent and
long lasting. Commonly prescribed medications include bromocriptine (Parlodel)
and cabergoline (Dostinex). These drugs decrease prolactin production
and may shrink the tumor in most people with prolactinoma.
If medication effectively shrinks the tumor and your prolactin level
remains normal afterward, you may be able to stop taking the medication.
Your doctor can offer you advice on when this may be possible for you.
Surgery
If drug therapy for the treatment of prolactinoma is unsuccessful or not
tolerated, surgery may be an option for the removal of a pituitary
tumor. It may also be necessary to relieve pressure on the nerves that
control your vision.
The outcome of surgery depends on the size of the tumor and if your
prolactin level is extremely high. The higher the prolactin level, the
less there's a chance of normalizing prolactin production with
medication. Surgery corrects the prolactin level in most people with
small pituitary tumors. However, many pituitary tumors recur within five
years after surgical removal. For people with larger tumors that can
only be partially removed, drug therapy often can return the prolactin
level to a normal range after surgery.
Prolactinoma
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