Prolactinoma
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Prolactinoma
Endocrine system
Adrenal gland disorders
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Thyroid gland disorders
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Hypothyroidism
Euthyroid sick syndrome
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Riedel thyroiditis
Postpartum thyroiditis
Thyroid cancer
Parathyroid gland disorders
Hyperparathyroidism
Hypoparathyroidism
Hypercalcemia
Hypocalcemia
Pancreatic disorders
Diabetes mellitus
Diabetic retinopathy
Diabetic nephropathy
Pituitary gland disorders
Hyperpituitarism
Pituitary adenoma
Hyperprolactinemia
Prolactinoma
Gigantism
Acromegaly
Hypopituitarism
Growth hormone deficiency
Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Polyglandular syndromes
Autoimmune polyglandular syndrome type 1 (NORD)
Endocrine tumors
Multiple endocrine neoplasia
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
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Amenorrhea
pituitary prolactinomas p. 335
Galactorrhea
pituitary prolactinomas p. 335
Hypogonadism
pituitary prolactinomas p. 335
Osteoporosis p. 472
pituitary prolactinomas p. 335
Pituitary prolactinomas p. 335
Prolactinomas
dopamine agonists for p. 334
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Transcript
Contributors
Sam Gillespie, BSc
With prolactinoma, prolactin refers to the endocrine hormone secreted by the pituitary gland and -oma refers to a tumor.
So a prolactinoma is a benign tumor, or adenoma, of the pituitary gland that secretes excess prolactin.
Normally, the pituitary is a pea-sized gland, hanging by a stalk from the base of the brain.
It sits just behind the eyes near something called the optic chiasm, which is where the optic nerves cross.
The anterior pituitary, which is the front of the pituitary gland, contains a few different types of cells, and each of which secretes a different hormone.
One group of cells in the anterior pituitary are called lactotrophs and they secrete prolactin.
Prolactin stimulates breast milk production.
Another group of cells are the gonadotrophs and they secrete two gonadotropic hormones - luteinizing hormone, or LH, and follicle-stimulating hormone, or FSH, both of which stimulate the ovaries in women which make estrogen and stimulate the testes in men which make testosterone.
Prolactin release is controlled by something called the hypothalamus, which is a structure at the base of the brain just above the pituitary gland.
It makes two key hormones, thyrotropin-releasing hormone which increases prolactin release, and dopamine, which inhibits the prolactin release and actually overrides the stimulatory effect of thyrotropin-releasing hormone.
That’s why dopamine is known as prolactin-inhibiting factor, and why it’s constantly released to prevent prolactin release in anyone that’s not pregnant.
Summary
A prolactinoma is a benign pituitary gland tumor that produces high levels of the hormone prolactin. Prolactin then suppresses the gonadotropin-releasing hormone resulting in symptoms like amenorrhea, galactorrhea, hypogonadism, gynecomastia, and erectile dysfunction in males. Treatment involves the use of dopamine agonist agents like bromocriptine which reduces the size of the tumor and lowers prolactin levels. In some cases, surgery or radiation therapy may also be required.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Harrison's Endocrinology, 4E" McGraw-Hill Education / Medical (2016)
- "Potential for long-term remission of microprolactinoma after withdrawal of dopamine-agonist therapy" Nature Clinical Practice Endocrinology & Metabolism (2006)
- "Demographic differences in incidence for pituitary adenoma" Pituitary (2010)
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