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Prolactinomas

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Benign tumors of the pituitary gland, known as lactotroph cells, are the source of prolactin, a hormone that regulates both genders' reproductive functions and causes lactation in females. These tumors are called prolactinomas. Excessive prolactin secretion from these tumors can cause a variety of symptoms as well as possible problems.Hyperprolactinemia, or high blood levels of prolactin, is one of the main signs and symptoms of prolactinomas. Men and women may experience this in various ways. It frequently results in irregular menstrual cycles, infertility, galactorrhea (spontaneous milk production),and amenorrhea (lack of menstruation) in women. Men may experience erectile dysfunction, decreased libido, and in certain situations, breast tissue expansion known as gynecomastia.Prolactinomas can range in size from tiny tumors to enormous masses. Tiny tumors, known as microadenomas, frequently go undetected during imaging testing for unrelated disorders and may not even show any symptoms. Macroadenomas, which are larger tumors, have the ability to compress neighboring brain structures. This can cause symptoms such as headaches, pressure on the adjoining optic nerves, and visual problems including blurred or lost peripheral vision.Prolactin levels are usually measured by blood tests, and imaging procedures like magnetic resonance imaging (MRI) are used to examine the pituitary gland and any accompanying malignancies. Treatment choices are determined by the tumor's size, how it affects nearby structures, the patient's symptoms, and their preferences.For prolactinomas, medication is frequently the first line of treatment. In order to decrease prolactin production and shrink the tumor, doctors frequently administer dopamine agonists like cabergoline and bromocriptine. These drugs work well to relieve symptoms, return prolactin levels to normal, and frequently shrink tumors.Surgery might be advised if prolactin levels are not sufficiently controlled by medication, if the tumor's size or location is causing severe neurological symptoms, or if none of these factors can be addressed. The most common surgical method for prolactinomas is transsphenoidal surgery, in which the tumor is removed through the nasal passages without the need for an exterior incision.Overall, prolactinomas have a relatively good prognosis with the right care. It is usually advised to periodically perform imaging examinations and routinely monitor prolactin levels in order to evaluate the efficacy of treatment and keep an eye out for any indications of tumor recurrence.