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Prolactinoma

A prolactinoma is a non-cancerous tumour of the pituitary gland. In prolactonima, the gland starts producing an excessive amount of the hormone called prolactin. Prolactin supports a woman’s normal lactation, but an excess of it can be harmful. Prolactinoma is the most common type of pituitary tumour. It is the pressure exerted by the tumour on surrounding tissues or the excessive release of prolactin into the blood that may result in the symptoms of prolactinoma. The cause of prolactinoma is not yet known.

It generally takes many years for prolactinoma to develop and the symptoms manifest very gradually. It can occur in both men and women, but it occurs more frequently in women, and the symptoms that manifest in women are erratic menstrual periods, which may even stop altogether or infertility. The symptoms which are seen only in men are erectile dysfunction and growth in the size of breasts. Some symptoms that are observed in both men and women are fluid oozing out of the nipples, or a lack of interest in sex. When the tumour grows large it exerts pressure on the surrounding tissues in the brain and may lead to headaches, a loss in the field of vision or hypopituitarism.

Diagnosis and treatment
If the doctors think a person might have prolactinoma, he will first determine whether pregnancy or drugs such as antipsychotics could be the cause of the increased levels of the hormone prolactin. Blood tests will determine the levels of the hormone prolactin, and if the levels are found to be too high, the patient may be asked to undergo MRI or CT scanning to observe whether a tumour is present. If a tumour is found, it can be treated with drugs that inhibit the production of prolactin, but if drugs do not work, the patient may have to undergo surgery to remove the tumour.

The prognosis
In three-fourth of the cases, treatment with drugs is effective, and in the others radiotherapy or surgery may be effective. Very rarely, it may occur again, and in such cases the treatment will have to be done all over again. After having undergone the treatment for the tumour, if a woman becomes pregnant, she will need constant monitoring as the tumour can occur again because of the changes in hormonal levels caused by pregnancy. Drugs to lower the levels of prolactin cannot be given during pregnancy.

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