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Prolactinoma
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Prolactinoma

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

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 > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/15/08 01:57 AM