Prolactin-secreting pituitary adenomas are common in hypothalamic-pituitary disorders caused by excessive synthesis and secretion of prolactin (PRL) by prolactin cells in the anterior pituitary. Statistics can account for 40% -60% of secretory pituitary adenomas. The incidence of female pituitary adenomas is higher than that of male pituitary adenomas. The peak of morbidity is about 30 years old, and the incidence decreases gradually after 50 years old.
What are the manifestations
of prolactin pituitary adenoma?
Clinical signs
of prolactin-secreting pituitary adenomas is different
in men and women The main manifestations of
female patients are irregular menstruation, lactation, headache, visual impairment, infertility and weight gain. Because female patients often have endocrine symptoms such as menstrual disorders, amenorrhea and galactorrhea earlier, and prolactinoma mostly occurs in adolescent and reproductive women, female patients generally see a doctor earlier than men.
The main manifestations of male
patients were headache, decreased vision, decreased sexual function, weight gain, breast development and so on.
What tests are needed to
diagnose the disease?
1. Laboratory examination
Basal prolactin (PRL) determination: blood PRL basal concentration was determined by taking a blood sample;
Blood PRL below 20 μg/L: hyperprolactinemia can be excluded;
20-40 μg
/L: repeated determination is required;
20-200 μg
/L: seen in pituitary tumors, but also seen in other causes of elevated prolactin;
More than 200 μg/L: the possibility of pituitary tumor is very high.
2. CT and MRI examination
of sella turcica region CT and MRI of
the sella turcica are commonly used imaging methods. MRI is superior to CT in many aspects, such as the localization and qualitative diagnosis of sellar lesions, and the detection of pituitary microadenomas. Therefore, MRI is the most valuable imaging method to observe sellar lesions, especially for pituitary adenomas.
At present, the clinical treatment of prolactinoma mainly includes drug therapy and surgical treatment.
Drug therapy is the first choice in the treatment
of prolactinoma. From the clinical effect point of view, drug (bromocriptine) treatment can promote tumor volume reduction, or even cure, if there is no remission after drug treatment, patients can wait until pituitary adenoma apoplexy or significant enlargement, consider the issue of surgery. Of course, if the side effects of drug treatment are serious, it can also be treated by surgery.
Surgical treatment
of prolactin-secreting pituitary adenomas is extremely effective. According to statistics, 60% to 90% of patients achieve normal prolactin levels after surgery. Of course, the effect of surgery is also affected by the experience of the operator, the size of the tumor and whether it is invasive. Therefore, it is better for patients to choose bigger hospitals and hospitals with stronger neurosurgery.
