Prolactinoma

Are you experiencing decreased sexual interest along with frequent headaches of late? Chances are that you may be suffering from a common pituitary gland disorder, known as Prolactino, affecting both sexes equally. Read and know more about this rare condition including its incidence, symptoms, causes, diagnosis and treatment.

What is Prolactinoma?

It is a noncancerous benign pituitary tumor of the pituitary gland, which is responsible for over-producing a special type of hormone called Prolactin (fuels the breasts to generate milk during the pregnancy period). Due to increased levels of prolactin, the sex hormones (testosterone in men and estrogen in women) reduce significantly. It is one of the most common types of pituitary tumor affecting the people.

This disorder is also known by the following names:

  • Galactorrhea-Amenorrhea Syndrome
  • Amenorrhea-Galactorrhea, Nonpuerperal
  • Forbes-Albright Syndrome
  • Nonpuerperal Galactorrhea

Prolactinoma ICD9 Code

The ICD9 code for this disorder is 253.1.

Prolactinoma Incidence

Forbes-Albright Syndrome is one of the most common types of pituitary tumors. According to medical studies, 25-30% of all US inhabitants have tiny tumors in their pituitary gland. Out of these, 40% of the people suffer from pituitary Prolactinoma. The condition is 5 times more common in women than in men and generally occurs in people who are under the age of 40.

Prolactinoma Causes

Nonpuerperal Galactorrhea is defined by the increase in the prolactin level (up to mlU/L). The actual cause of this syndrome is still unknown. However, intense stress can increase the level of prolactin in the body and give rise to this sporadic disease. The disorder can occur as a part of a genetic condition known as MEN1- multiple endocrine neoplasia type 1. In a few patients, the prolactin level in the blood can increase due to:

Prescribed Drugs

The production of prolactin can be concealed by a brain chemical, known as dopamine. However, there are a few drugs that reduce the effects of dopamine, causing the pituitary glands to secrete prolactin in large quantity. Such drugs include haloperidol, antipsychotic drugs such as risperidone, molindone, trifluoperazine, metoclopramide, verapamil, alpha-methyldopa, haloperidol and reserpine.

Hypothyroidism

People affected with hypothyroidism often experience increased prolactin levels. Doctors keep a tab on the occurrence of hyperprolactinemia among the individuals affected by hypothyroidism.

Chest involvement

A chest injury or shingles, which involves the chest, can also cause this pituitary syndrome.

Prolactinoma Symptoms

Sometimes, no warning signs or indications of prolactinoma are visible. Symptoms of this disorder are only noticeable when the tumor has increased in size or due to excessive prolactin secretion in your blood. As a result of increased levels of prolactin hormone, the reproductive system of the affected patient experiences severe disruption.

The warning signs of Forbes-Albright Syndrome are precise in males and females.

Prolactinoma symptoms in males

These include:

  • Gynecomastia
  • Impotency
  • Vision problems (such as Visual field loss, Double vision and Drooping eyelids)
  • Nasal Drainage
  • Inability to smell things
  • Low sexual desire
  • Headache
  • Infertility
  • Lethargy
  • Vomiting and nausea

Prolactinoma in females

These involve:

  • Breast tenderness
  • Headache
  • Irregular menstruation
  • Galactorrhea
  • Low sexual desire
  • Infertility
  • Vision problems

Prolactinoma Diagnosis

Abnormal secretion of milk or infertility defines the existence of high prolactin levels in women. In men, the diagnosis of this disorder is determined by impaired sexual function. The diagnostic procedures which help to determine the exact condition this syndrome may include:

Brain Scan

A proper MRI scan of your brain will assist in determining the presence of any tumor in the pituitary gland.

Vision Test

Vision tests help to determine the presence of tumor in the pituitary gland.  The patient may be suffering from peripheral vision or impaired sight.

Blood Test

Such therapy is required to determine the surplus production of prolactin. This procedure also helps to determine the hormone level administered by pituitary gland.

Prolactinoma Treatment

Not each and every patient affected by this disorder requires treatment. Accurate treatment can improve infertility and abnormal milk flow among the females while males can be treated for impotency. The professional medical treatment options required to cure this syndrome involve:

Medications

Drugs such as bromocriptine and cabergoline, which act as a dopamine agonist, are prescribed to patients. Such drugs inhibit the secretion of prolactin in the body.

Surgery

This therapy is only recommended to patients where the tumor has harmed the vision to a great extent. When medicines are unsuccessful in reducing the prolactin level in the body, surgery is advised to such patients to minimize the size of the tumors. The type of surgery solely depends on the extent and overall size of the tumor in the pituitary gland. Two major operative techniques include:

Transsphenoidal surgery

In this form of surgery, the tumor is completely removed from the nasal cavity. Since no other parts of brain are touched during surgery, only a handful of complications arise. This surgery does not leave any mark on the body.

Transcranial surgery

If the size of the tumor increases tremendously or spreads to the proximal tissue areas, a transcranial surgery is needed. In this process, the tumor is operated via the apex of the skull.

Radiation

When medication or surgery cannot treat this disorder in patients, radiotherapy is highly recommended.  This therapy is given in two forms:

  • Gamma knife or stereotactic radiosurgery
  • Conventional radiation

Prolactinoma Prognosis

The outcome of patients is based on the accomplishment of medical treatment or surgery. It is mandatory to check whether the tumor has originated after successful treatment or not. The cure for this disorder may alter the levels of different hormones in the body of the patient, when surgery is done. Growth of Prolactinoma can also be triggered by testosterone or estrogen growth.

Prolactinoma and Pregnancy

It is common among patients to suffer from high levels of prolactin due to presence of tumor. Women suffering from this disease should consult a doctor before consuming birth control pills.

Prolactinoma Complications

The primary complication arising out of this disorder is Osteoporosis (thinning of bones). It occurs when the high prolactin levels are not treated for a long period of time. Macro prolactinomas may cause a number of severe complications in the brain, pituitary gland and nerves of the eye. To prevent the occurrence of such complications, large prolactinomas should be given proper treatment. If treatment is not given to such patients, it will lead to vision loss and severe headaches.

If you suspect yourself or your partner to be showing the signs and symptoms of this disease, or have a medical history of the disorder, call your family health care provider.

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