*What is Prolactinoma?*
The pituitary is a small gland in the endocrine system located at the base of the brain and sits in the sella turcica. Don't let its small size fool you though! It influences nearly every part of your body! Some of the things that it helps regulate are growth, reproduction, and blood pressure. The pituitary also produces a hormone called Prolactin which stimulates breast milk production in females, but this type of tumor can also occur in men. Although the cause of pituitary tumors is yet unknown, Prolactinoma is the most common type of pituitary tumor. These tumors are almost always noncancerous, but they can increase in size. They tend to occur more commonly in women rather than men, and they are very rare for children. People with Prolactinomas tend to develop them under 40 years of age, but they tend to develop in younger ages for women and older ages for men.
*Symptoms*
The symptoms of Prolactinoma result from excess prolactin in the blood and from pressure on the surrounding tissues. Because the area that the pituitary is housed in is so small, when the tumor grows it can compress your optic nerve and cause visual disturbances. Other symptoms that can occur in both males and females are headaches and infertility. In women, missed or irregular menstrual cycles or production of breast milk when not pregnant or breast feeding are also common symptoms. In men, erectile dysfunction and uncommonly enlarged breasts are key symptoms. Women usually tend to notice a problem earlier than men because of the missed or irregular menstrual cycles, whereas men don't really seem to notice until the tumor gets much larger and presses on the optic nerve causing headaches and vision problems.
*Diagnosis*
The most sensitive study available to detect a pituitary tumor is MRI, although a CT scan can also be done. Also, your doctor may test prolactin levels in your blood or he may also perform a vision test to see if the growth of the tumor has impaired your vision.
*Treatment*
The 2 main treatments for Prolactinoma are medication or surgery. Medication is usually a long-term process that reduces the levels of prolactin in the blood and may also shrink the tumor. If medication shrinks the tumor and your prolactin levels remain at a normal level, you may be able to stop taking the medication. Surgery is typically done if the medication is not successful or is not tolerated by the patient. It may also be necessary to relieve pressure on the optic nerves, in which case removal of the tumor may be necessary. The most common surgery performed is removing the tumor through the nasal cavity.
This is a sagittal T1 weighted MRI image of a Prolactinoma in a 27-year-old female who was 32 weeks pregnant. She complained of headaches and vision problems.
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http://radiographics.rsnajnls.org/cgi/content-nw/full/27/1/95/F12B
This is the coronal T1 weighted MRI image of the same 27-year-old female.
http://radiographics.rsnajnls.org/cgi/content-nw/full/27/1/95/F12A
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