{"entity":{"id":"lactotroph-pitnet","kind":"cancer","name":"Lactotroph pituitary neuroendocrine tumour (prolactinoma)","aka":["Prolactinoma","Lactotroph tumour","Lactotroph tumour (prolactinoma)","Prolactin-secreting pituitary adenoma","Lactotroph adenoma"],"tldr":"A prolactinoma is a pituitary tumour of the cells that make prolactin, the milk hormone; it is the commonest hormone-producing pituitary tumour and causes missed periods, infertility, milk production or, in men, low testosterone. Almost uniquely among tumours it is treated first with a tablet, cabergoline, which shrinks it in most people; surgery is kept for those the drug fails.","summary":"The 2022 WHO classification of endocrine tumours reclassifies pituitary adenomas as pituitary neuroendocrine tumours (PitNETs) and types them by transcription factor lineage, the lactotroph tumour belonging to the PIT1 lineage with sparsely or densely granulated subtypes, defined by prolactin and oestrogen receptor alpha expression (Asa 2022). The Pituitary Society's 2023 international consensus covers epidemiology, biochemical evaluation of hyperprolactinaemia, imaging, treatment with dopamine agonists including efficacy, adverse effects and withdrawal, indications for surgery and radiotherapy, and management in pregnancy, children, psychiatric illness, postmenopausal women, transgender people and kidney disease; it concludes that treatment resistance is rare but that new options and international registries are needed (Petersenn 2023).\n\nHow it differs from its parent: the parent page covers all pituitary tumours; the lactotroph tumour is the one treated medically first, the one whose macroadenomas in women and men respond to cabergoline with tumour shrinkage, and the one where surgery has become a first-line alternative for small well-defined tumours in some guidelines.\n\nHow common: the most prevalent functioning pituitary tumour (Petersenn 2023); no separate incidence figure in the sources read.\n\nTreatment: cabergoline (or bromocriptine) as first-line therapy with attempted withdrawal after prolonged normalisation and tumour shrinkage; transsphenoidal surgery for intolerance, resistance, cystic tumours or patient preference; radiotherapy and temozolomide for the rare aggressive or giant prolactinoma, as on the parent page (Petersenn 2023).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Prolactinoma","links":[{"label":"NCI PDQ: pituitary tumours treatment","url":"https://www.cancer.gov/types/pituitary/treatment"},{"label":"Asa 2022, Endocrine Pathology: overview of the 2022 WHO classification of pituitary tumours","url":"https://doi.org/10.1007/s12022-022-09703-7"},{"label":"Petersenn 2023, Nature Reviews Endocrinology: Pituitary Society international consensus on prolactin-secreting pituitary adenomas","url":"https://doi.org/10.1038/s41574-023-00886-5"}],"tags":["subtype-page","wave4","rare"],"related":["pituitary-tumours","somatotroph-pitnet","corticotroph-pitnet","gonadotroph-pitnet","thyrotroph-pitnet","men1-syndrome"],"cancers":[],"sections":[],"technologies":["radiosurgery-srs"],"targets":[],"drugs":["cabergoline","bromocriptine","temozolomide"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"endocrine","burden":"The most prevalent functioning pituitary tumour (Pituitary Society consensus 2023); the parent page gives the pituitary tumour figures, and GLOBOCAN does not count pituitary tumours.","subtypes":["Sparsely granulated lactotroph pituitary tumour (the common prolactinoma)","Densely granulated lactotroph pituitary tumour","Giant or aggressive prolactinoma (dopamine agonist-resistant)","Mixed somatotroph-lactotroph or mammosomatotroph tumour (PIT1 lineage)"],"biomarkers":["Serum prolactin (with macroprolactin and hook-effect checks)","PIT1 and oestrogen receptor alpha lineage markers; prolactin immunostaining","Pituitary MRI (micro- versus macroadenoma; cavernous sinus invasion)","Ki-67 and mitoses (aggressiveness)"],"standardOfCare":[{"setting":"First line","approach":"Cabergoline (or bromocriptine), with attempted withdrawal after prolonged normalisation and shrinkage.","refs":["cabergoline","bromocriptine","pituitary-tumours"]},{"setting":"Resistant, intolerant or aggressive","approach":"Transsphenoidal surgery; radiotherapy and temozolomide for aggressive or giant tumours as on the parent page.","refs":["radiosurgery-srs","temozolomide","pituitary-tumours"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"pituitary-tumours"},"route":"/cancers/lactotroph-pitnet/","neighbours":{"cancer":[{"id":"corticotroph-pitnet","kind":"cancer","name":"Corticotroph pituitary neuroendocrine tumour (Cushing disease and silent corticotroph tumour)","route":"/cancers/corticotroph-pitnet/"},{"id":"gonadotroph-pitnet","kind":"cancer","name":"Gonadotroph pituitary neuroendocrine tumour (non-functioning adenoma)","route":"/cancers/gonadotroph-pitnet/"},{"id":"men1-syndrome","kind":"cancer","name":"Multiple endocrine neoplasia type 1 (MEN1)","route":"/cancers/men1-syndrome/"},{"id":"pituitary-tumours","kind":"cancer","name":"Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma","route":"/cancers/pituitary-tumours/"},{"id":"somatotroph-pitnet","kind":"cancer","name":"Somatotroph pituitary neuroendocrine tumour (acromegaly)","route":"/cancers/somatotroph-pitnet/"},{"id":"thyrotroph-pitnet","kind":"cancer","name":"Thyrotroph pituitary neuroendocrine tumour (TSH-secreting)","route":"/cancers/thyrotroph-pitnet/"}],"technology":[{"id":"radiosurgery-srs","kind":"technology","name":"Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)","route":"/technologies/radiosurgery-srs/"}],"drug":[{"id":"bromocriptine","kind":"drug","name":"Bromocriptine","route":"/drugs/bromocriptine/"},{"id":"cabergoline","kind":"drug","name":"Cabergoline","route":"/drugs/cabergoline/"},{"id":"temozolomide","kind":"drug","name":"Temozolomide","route":"/drugs/temozolomide/"}]}}