Prolactinoma natural history, complications, and prognosis: Difference between revisions

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{{Prolactinoma}}
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==Overview==
==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==
==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.<ref name="pmid15191331">{{cite journal| author=Liu JK, Couldwell WT| title=Contemporary management of prolactinomas. | journal=Neurosurg Focus | year= 2004 | volume= 16 | issue= 4 | pages= E2 | pmid=15191331 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15191331  }} </ref>


==Complications==
==Complications==
Complications of [[prolactinoma]] include:
*[[Pituitary apoplexy]]<ref name="pmid15191331">{{cite journal| author=Liu JK, Couldwell WT| title=Contemporary management of prolactinomas. | journal=Neurosurg Focus | year= 2004 | volume= 16 | issue= 4 | pages= E2 | pmid=15191331 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15191331  }} </ref>
** [[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]].


=== Osteoporosis Risk ===
{{Family tree/start}}
[[Hyperprolactinemia]] can cause reduced [[estrogen]] production in women and reduced [[testosterone]] production in men.  Although estrogen/testosterone production may be restored after treatment for hyperprolactinemia, even a year or two without estrogen/testosterone can compromise bone strength, and patients should protect themselves from osteoporosis by increasing exercise and [[calcium]] intake through diet or supplementation, and by avoiding smoking. Patients may want to have bone density measurements to assess the effect of estrogen/testosterone deficiency on bone density. They may also want to discuss testosterone/estrogen replacement therapy with their physician.
{{Family tree | | | | A01 | | | |A01= Hemorrhage and/or infarction in prolactinoma}}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | B01 | | | |B01= Rapid enlargement of tumor}}
{{Family tree | | | | |!| | | | | }}
{{Family tree | | | | C01 | | | |C01= Compression of sella and para sellar structures}}
{{Family tree/end}}


== Prognosis ==
*[[Tumor]] regrowth (after resection)
People with microprolactinoma generally have an excellent prognosis.  In 95% of cases the tumor will not show any signs of growth after a 4 to 6 year period.
*[[Blindness]]
*In [[pregnancy]], excessive [[estrogen]] may cause increased [[tumor]] growth


Macroprolactinomas often require more aggressive treatment otherwise they may continue to grow. There is no way to reliably predict the rate of growth, as it is different for every individual. Regular monitoring by a specialist to detect any major changes in the tumor is recommended.
==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.<ref>http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx</ref>


== References ==
==References==
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Latest revision as of 23:49, 29 July 2020

Prolactinoma Microchapters

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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:

 
 
 
Hemorrhage and/or infarction in prolactinoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rapid enlargement of tumor
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Compression of sella and para sellar structures
 
 
 

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

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