Prolactinoma

Definition

A prolactinoma is an abnormal growth, or tumor, on the pituitary gland. The tumor causes the
pituitary to produce too much prolactin leading to hyperprolactinemia. Prolactinomas are the
most common hormone-secreting pituitary tumors.

Etiology

Tumors arising from lactotrope cells account for about half of all functioning pituitary tumors.
Mixed tumors that secrete combinations of GH and PRL, ACTH and PRL, and rarely TSH and
PRL,

are

also

seen.

These

plurihormonal

tumors

are

usually

recognized

by

immunohistochemistry, sometimes without apparent clinical manifestations from the production

of additional hormones.
Presentation

PRL inhibits reproductive function by suppressing hypothalamic GnRH and pituitary

gonadotropin secretion and by impairing gonadal steroidogenesis.

Women usually present with amenorrhea, infertility, and galactorrhea. If tumor extends outside
the sella, visual field defects or other mass effects may be seen. If sustained, vertebral bone
mineral density decreases particularly when associated with hypoestrogenemia.

Men often present with impotence, loss of libido, infertility, or signs of central CNS compression,
including headaches, and visual defects.