Prolactinoma

Prolactinomas represent approximately 50% of all pituitary adenomas, with a female preponderance.

Women usually present with amenorrhoea and galactorrhoea. Men may present with sexual dysfunction, hypogonadism, and sometimes gynaecomastia, all related to the hyperprolactinaemia.

Premenopausal women present earlier due to menstrual irregularity and hence usually have microprolactinomas. Men and post-menopausal women often present later with macroadenomas, which may be invasive or giant tumours.

Treatment with dopamine agonists usually results in prolactin normalisation, symptom improvement, and tumour shrinkage.

Prolactinomas are benign lactotroph adenomas expressing and secreting prolactin.