1887
Volume 2008, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Objectives: To describe the clinical features of prolactin-producing pituitary adenoma (prolactinoma) in adult patients.

Methods: In a prospective hospital-based study, adult patients with prolactinoma presenting to the National Center for Neurological diseases and the National Center for cancer in Khartoum, Sudan were enrolled in the period from January 2001 to February 2005. The diagnosis was based on finding a pituitary adenoma on cranial MRI and an associated elevated blood prolactin level above 200 pig/L. The size of the adenoma was classified as either microadenoma ( < 10 mm without sellar enlargement or extrasellar extension) ormacroadema (>10 mm). The hormone profile done on each patient included blood level of prolactinand other pituitary trophic hormones, free triiodothyronine and free thyroxine hormones.

Results: Sixteen (14 females and 2 males) were identified as having a prolactinoma. The female to male ratio was 7:1. Their mean age was 24 ± 5.1 years. The prolactinoma was macroadenoma in 9 cases and microademoma in 7. Galactorrhea, amenorrhea and infertility (primary or secondary) were the commonest presenting symptom followed by headache. Affection of the visual pathway, either as bitemporal hemianopia (41.2%) or optic atrophy (11.8%), was the major neurological deficit. The mean prolactin level in macroadenoma was 2053 ± 442.6 jig/L and in microadenoma was 853.6 ± 77.8 jig/L.

Conclusions: Our prolactinoma patients, when reaching the appropriate medical attention, are more likely having an expanded macroadeoma that is compromising the visual pathway. Early recognition and referral to specialized clinics is necessary and that should have a favorable prognostic implication.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2008.2.13
٢٠٠٨-١٢-٠١
٢٠٢٤-٠٧-١٦
Loading full text...

Full text loading...

References

  1. Surawics TS, McCarthy BJ, Kupelian V, Jukich PJ, Bruner JM, Davis FG. Descriptive epidemiology of primary brain and CNS tumors: result from the central brain tumor registry of the United States. 1995–1999. Neuro-oncol. 1999; 1::1425.
    [Google الباحث العلمي]
  2. Russell EJ, Molitch ME. The pituitary «incidentaloma». Ann Intern Med. 1990; 112::925931.
    [Google الباحث العلمي]
  3. Zargar AH, Laway BA, Masoodi SR, Salahuddin M, Ganie MA, Bhat MH, Wani Al, Bashir MI. Clinical and endocrinological aspects of pituitary tumors. Saudi Med J. 2004; 25::14281432.
    [Google الباحث العلمي]
  4. Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinoma. Pituitar. 2005; 8::36.
    [Google الباحث العلمي]
  5. Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A. High prevalence of pituitary adenomas: A cross sectional study in province of Liege, Belgium. J Clin Endonol Metab. 2006; 91::47694775.
    [Google الباحث العلمي]
  6. Casanueva FF, Molitch ME, Schlechte JA, Abs R, Bonert V, Bronstein MD, Brue T, Cappabianca P, Colao A, Fahlbusch R, Fideleff H, Hadani M, Kelly P, Kleinberg D, Laws E, Marek J, Scanlon M, Sobrinho LG, Wass JA, Giustina A. Guidelines of the pituitary society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). 2006; 65::265.
    [Google الباحث العلمي]
  7. Molitche ME. Medical management of prolactin-secreting pituitary adenoma. Pituitary. 2002; 5::5565.
    [Google الباحث العلمي]
  8. Colao A, Di Sarno A, Landi ML, Cirillo S, Sarnacchiaro F, Faciolli G, Pivonello R, Cataldi M, Merola B, Annunziato L, Lombardi G. Long-term and low-dose treatment with cabergoline induced macroprolactinoma shrinkage. J Clin Endocrinol Metab. 1997; 82::35743579.
    [Google الباحث العلمي]
  9. Orrego JJ, Chandler WF, Barkan AL. Pergolide as a primary therapy for macroprolactinoma. Pituitary. 2000; 3::251256.
    [Google الباحث العلمي]
  10. Aron DC, Tyrrel JB, Wilson CB. Pituitary tumors: Current concepts in diagnosis and management. West J Med. 1995; 162::340352.
    [Google الباحث العلمي]
  11. Asano S, Ueki K, Suzuki I, Kirino T. Clinical features and medical treatment of male prolactinomas. Acta Neurochir (Wien). 2001; 143::465470.
    [Google الباحث العلمي]
  12. Nishioka H, Ito H, Haraoka J, Hirano A. Growth potential of female prolactinoma. Surg Neurol. 2001; 55::213217.
    [Google الباحث العلمي]
  13. Ma W, Ikeda H, Yoshimoto T. Clinicopathologic study of 123 cases of prolactin-producing pituitary adenomas with special reference to multihormone production and clonality of the adenomas. Cancer. 2002; 95::258266.
    [Google الباحث العلمي]
  14. Randall RV, Scheithauer BW, Laws ER Jr, Abbound CF, Ebersold MJ, Kao PC. Pituitar adenomas associated with hyperprolactinemia: a clinical and immunohistochemical study of 97 patients operated transsphenoidally. Mayo Clin Proc. 1985; 60::753762.
    [Google الباحث العلمي]
  15. De Rosa M, Ciccarelli A, Zarrilli S, Guerra E, Gaccione M, Di Sarno A, Lombardi G, Colao A. The treatment for 24 months normalizes the quality of seminal fluid in hyperprolactinaemic males. Clin Endocrinol (Oxf). 2006; 64::307313.
    [Google الباحث العلمي]
  16. Ciccarelli A, Guerra E, De Rosa M, Milone F, Zarrilli S, Lombardi G, Colao A. PRL-secreting adenomas in male patients. Pituitary. 2005; 8:1:3942.
    [Google الباحث العلمي]
  17. De Rosa M, Colao A, Di Sarno A, Ferone D, Landi ML, Zarrilli S, Paesano L, Merola B, Lombardi G. Cabergoline rapidly improves gonadal function in hyperprolactinemic males: A comparison with bromocriptine. Eur J Endocrinol. 1998; 138::286293.
    [Google الباحث العلمي]
  18. Feigenbaum SL, Downey DE, Wilson CB, Jaffe RB. Transsphenoidal pituitary resection for preoperative diagnosis of prolactin-secreting pituitary adenoma in women: long term follow-up. J Clin Endocrinol Metab. 1996; 81::17111719.
    [Google الباحث العلمي]
  19. Wolfsberger S, Czech T, Vierhapper H, Benavente R, Knosp E. Microprolactinomas in males treated by transphenoidal surgery. Acta Neurochir (Wein). 2003; 145::935940.
    [Google الباحث العلمي]
  20. Tsagarakis S, Grossman A, Plowman PN, Jones AE, Touzel R, Rees LH, Wass JA, Besser GM. Megavoltage pituitary irradiation in the management of prolactinomas: long-tem follow-up. Clin Endocrinol (Oxf). 1991; 34::399406.
    [Google الباحث العلمي]
  21. Littley MD, Shalet SM, Reid H, Beardwell CG, Sutton ML. The effect of external pituitary irradiation on elevated serum prolactin levels in patients with pituitary macroadenoma. QJ Med. 1991; 81::985998.
    [Google الباحث العلمي]
/content/journals/10.5339/qmj.2008.2.13
Loading
  • نوع المستند: Research Article

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error