Clinical manifestations, laboratory and image findings in patients with prolactinoma

Abstract

Objective: to describe clinical manifestations, laboratory, image findings and therapeutic outcomes in patients with prolactinoma.

Methods: descriptive prospective study on 30 patients with prolactinoma admitted to Bach Mai hospital and National hospital of obstetrics and gynecology. We directly examined, described, evaluated laboratory tests and magnetic resonance imaging. The information were completed in specific protocol.

Results: From 11/2016 to 9/2017, we observed 33 patients with prolactinoma. There were 29 females (87.9%) and 4 males (12.1%) with mean age was 32.7 ± 10. The most common clinical manifestations in men was visual field defects (3/3) and headache (2/3). In women, more than half of these patients had infertility (68.9%), menstrual disorder (62.1%), and galactorrhea (55.2%). The mean duration of symptoms was 3 years. The mean plasma prolactin levels at diagnosis was 493.4 ng/ml. In this group, more than half of them had microadenomas (54.5%) and macroadenoma was 45.5%. There was a direct correlation between plasma prolactin levels > 200 ng/ml with tumor size.

Conclusion: Clinical manifestations at presentation differed withsexes, in which menstrual disorder, galactorrhea infertility were mostly seen in women; visual field defects and headache were seen in men. Plasma prolactin levels > 200 ng/ml suggested a macroadenoma. On pituitary magnetic resonance imaging, microadenomas with tumors < 10 mm in diameter were found more frequent in women; tumors ≥ 10 mm were observed more frequent in men.