Prolactinoma is the appearance of benign tumors in the pituitary gland (pituitary) located at the base of the brain. This gland works to produce several types of hormones, one of which is prolactin. Prolactinomas cause prolactin to be overproduced by the pituitary gland. In effect, the production of sex hormones, namely testosterone in men and estrogen in women, will be reduced.
Prolactinomas occur when some cells in the pituitary gland grow and overgrow, thereby forming a tumor. Based on the size, there are three types of prolaktinoma known in the medical world, namely microprolactinoma (measuring less than 10 mm), macroprolactinoma (more than 10 mm), and giant prolactinoma (more than 4 cm).
Although prolactinoma is not malignant and non-life-threatening, this condition can cause vision problems, sterility, and cause some other problems. Treatment of prolactinoma is done to restore prolactin levels to normal conditions and make the pituitary gland work in accordance with its function.
Prolactinomas can occur in men and women of all ages. However, this case is most often found in women aged 20-50 years or before menopause. The signs of prolactinoma appear in men and women are not the same. Symptoms of prolactinoma in women include:
- Sexual desire decreases.
- Pain during intercourse due to dry vagina.
- Menstruation is irregular.
- Milk production is disrupted.
- Having fertility problems.
- Acne appears and excessive hair growth in certain body parts.
Signs of prolactinoma in women are more easily known, so women more quickly realize the appearance of prolactinoma when the tumor is still small.
Unlike women, men often just realize the emergence of prolactinoma when the tumor is enlarged. Some of the symptoms of prolactinoma in men are:
- Sexual desire decreases.
- Erection is disturbed.
- Impaired vision.
- Breast enlargement (rare).
This disease can also be experienced by children and adolescents. If it occurs in children and adolescents, their development may become constrained and puberty is delayed.
Causes of Prolactinoma
Until now still not known the exact cause of prolactinoma. But there are several factors that allegedly can make prolactin production becomes excessive. Some of these factors include the influence of certain treatments, chest injuries, pregnancy and lactation, the appearance of other tumors in the pituitary gland, or due to the influence of underactive thyroid gland.
Diagnosis of Prolactinoma
To diagnose prolactinoma, the doctor will perform an examination that includes:
- Examination of blood, to measure levels of prolactin and other hormones that are controlled by the pituitary gland.
- Examination of the eyes, to see whether tumors that grow in the pituitary gland cause vision impairment or not.
- Brain scans, to get a clear picture of the brain condition, shape, and size of the tumor in the pituitary gland.
If necessary, your doctor may advise the patient to undergo further examination with the help of an endocrinologist.
In many cases, dopamine agonists, such as cabergoline and bromocriptine, are very effective against prolactinomas. Drug dopamine agonists will normalize the function of the pituitary gland in producing prolactin and reduce the size of the tumor. These drugs can make prolactin levels back to normal in a few weeks.
The surgical procedure can also be done as an alternative if treatment with dopamine agonists does not work to cure prolactinoma. There are two types of surgery used to treat prolactinoma, namely:
- Transsphenoidal surgery. This surgery is performed by the doctor to reach the pituitary gland through the sphenoid bone, by making a small incision over the front teeth or from inside the nostrils.
- Transcranial operation. This operation is performed if the tumor is large and has spread to the brain tissue. The doctor will reach the pituitary gland through the upper part of the skull bone.