Clinical, Radiologic, and Follow-Up Findings in Patients With Macroprolactinoma

Abstract

OBJECTIVE: The objective of this study was to describe the clinical, therapeutic, and follow-up findings of patients with macroprolactinoma cared for in a specialized hospital. METHODS: The authors conducted a retrospective analysis of 32 patients with macroprolactinoma (19 women and 13 men) with a mean duration of follow up of 7.2 ± 5.2 years. Clinical manifestations, serum prolactin level, and tumor extension at diagnosis and after receiving treatment are analyzed. RESULTS: The predominant initial clinical manifestations in women were oligo-/amenorrhea (94.7%), headaches (58%), and galactorrhea (52.6%), whereas in men, compressive clinical manifestations (61.5% with visual field alterations) and the deficit of other pituitary hormones (30.7% with hypopituitarism) were predominant. The men presented higher serum prolactin levels (4.366 ± 5.031 vs 1.352 ± 2.917 ng/dL; P = 0.09) and greater degree of tumor invasion (100% vs 63.2; P = 0.01). The patients treated exclusively with dopamine agonists (DA) (78%) showed a considerable improvement in clinical manifestations, prolactin level, and tumor shrinkage. Seven patients received surgical treatment, 85% of whom needed treatment with DA because of persistence of hyperprolactinemia. CONCLUSIONS: The clinical and radiologic presentation of macroprolactinoma is more aggressive in men than in women, and in both sexes, treatment with dopamine agonists is effective both in controlling symptoms and in reducing serum prolactin levels and tumor size. Copyright © 2006 by Lippincott Williams & Wilkins.