Prolactinoma – What is it?
Prolactinoma is a type of pituitary tumor which mainly affects the production of Prolactin hormone in the body.
Pituitary tumors are abnormal growths seen developing in the pituitary gland which is located at the base of the skull. This is one of the smallest, yet most important, glands in the entire body as it not only secretes various important hormones, such as Prolactin, but is also responsible for controlling the production of other vital hormones as well.
Signs and Symptoms of Prolactinoma
In many cases of Prolactinoma, there may not be any noticeable signs or symptoms, however, in case the tumor starts to produce Prolactin at an abnormal level then the patient can notice and experience several common signs and symptoms.
As the increased level of Prolactin in the body disturbs the reproductive system in men and women, many signs and symptoms seen due to Prolactinoma are unique to men and women differently.
In women, Prolactinoma can result in:
- Late/early menstrual periods
- No menstrual periods
- Milky discharge from breasts without being pregnant/breast-feeding
- Vaginal dryness which causes pain during sexual intercourse
- Excessive body hair growth
In men, Prolactinoma can result in:
- Decrease in body/facial hair
- Erectile dysfunction
- Abnormally large breast (male breast/Gynecomastia)
The common signs and symptoms seen in men and women due to Prolactinoma are:
- Lower density of bones
- Production of other hormones is affected (hypopituitarism)
- Loss in libido (lowered sex drive)
- Vision problems
The signs and symptoms tend to be noticeable in women earlier as compared to men, even when the tumor in the pituitary gland is comparatively smaller in size as the abnormality with the menstrual periods is seen faster. Men tend to notice the signs and symptoms when the tumor has grown comparatively larger and has started affecting the surrounding structure as well, such as putting pressure on the optic nerve which results in problems with the vision and headache.
The main aim of all forms of Prolactinoma treatment is to:
- Restore normal Prolactin levels in the body
- Decrease pituitary tumor size
- Restore pituitary gland functions to normal levels
- Treat all signs and symptoms being caused by pressure on the surrounding tissue from the large tumor in the pituitary gland (vision loss, headaches, etc.)
- Improve quality of life of the patient significantly
There are 2 main treatment methods for Prolactinoma:
Oral medications are mostly prescribed by doctors initially to eliminate the signs and symptoms as well as the size of the pituitary gland tumor. In some severe cases, it might be necessary to undergo a prolonged medication use.
These medications are mostly meant to mimic the effects of dopamine – the brain chemical which controls production of Prolactin in the body, but are stronger and longer-lasting. These drugs aim to decrease the production of Prolactin and to reduce the size of the tumor.
Surgical pituitary tumor treatment for Prolactinoma is useful in cases where the medications have proven unsuccessful in treating the tumor. This type of pituitary tumor surgery not only aims to remove the pituitary tumor but also to reduce the pressure on the surrounding tissue being caused by it.
These are the 2 common surgical methods for treatment of Prolactinoma:
- Trans-Cranial Surgery – In case the tumor is comparatively larger in size or it has metastasized (spread) to affect the surrounding tissues and organs, then the craniotomy approach is used. This requires accessing the tumor through a hole made in the top (crown) portion of the skull.
- Transsphenoidal Surgery – Majority of people who undergo a surgical removal of Prolactinoma (pituitary tumor) choose this method. This surgical approach requires the surgeon to access the tumor in the pituitary gland using minimally invasive surgical methods (microscope/endoscope) through the nose. This is a comparatively more beneficial surgical method for removal of Prolactinoma.
The results of the surgical treatment of Prolactinoma are dependent on various factors, mainly the location and the size of the tumor along with the skill and experience of the surgeon.