Prolactinoma natural history, complications, and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2], Faizan Sheraz, M.D. [3]

Overview

If left untreated, 95% of cases of prolactinoma will not show any signs of growth during the first 4 to 6 years. Complications of prolactinoma include pituitary apoplexy and vision loss. Prognosis is generally excellent for cases of microprolactinoma.

Natural History

If left untreated, 95% of cases of prolactinoma will not show any signs of growth during the first 4 to 6 years. Sometimes, it may lead to premature osteoporosis in both sexes due to hyperprolactinomia.^[1]

Complications

Complications of prolactinoma include:

Pituitary apoplexy^[1]
- Pituitary apoplexy usually presents with sudden onset of excruciating headache, diplopia, and visual impairment.
- Headache is most common symptom and is usually associated with nausea and vomiting.

Hemorrhage and/or infarction in prolactinoma

Rapid enlargement of tumor

Compression of sella and para sellar structures

Tumor regrowth (after resection)
Blindness
In pregnancy, excessive estrogen may cause increased tumor growth

Prognosis

Prognosis is excellent for cases of microprolactinoma.
Depending on the size of the tumor and the extent of tumor resection, the rate of recurrence may range from 20% to 50%.
The majority of recurrent prolactinomas develop within the first 5 years.^[2]

References

↑ ^1.0 ^1.1 Liu JK, Couldwell WT (2004). “Contemporary management of prolactinomas”. Neurosurg Focus. 16 (4): E2. PMID 15191331.
↑ http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx

Template:WikiDoc Sources

[pmid15191331-1] 1.0 ^1.1 Liu JK, Couldwell WT (2004). “Contemporary management of prolactinomas”. Neurosurg Focus. 16 (4): E2. PMID 15191331.

[2] ttp://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx

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