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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.
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).
How 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.
How common: the most prevalent functioning pituitary tumour (Petersenn 2023); no separate incidence figure in the sources read.
Treatment: 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).
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.
Gliomas infiltrate along white matter and can cross the corpus callosum, medulloblastoma sits in the cerebellum, and CNS lymphoma favours deep periventricular tissue; none spread through lymph nodes.
No conventional lymphatics: gliomas spread along white matter tracts and, rarely, through cerebrospinal fluid; medulloblastoma can seed the spine.
Same organ: Somatotroph pituitary neuroendocrine tumour (acromegaly), Corticotroph pituitary neuroendocrine tumour (Cushing disease and silent corticotroph tumour), Gonadotroph pituitary neuroendocrine tumour (non-functioning adenoma), Thyrotroph pituitary neuroendocrine tumour (TSH-secreting), Pineocytoma and pineal parenchymal tumour of intermediate differentiation, Pineoblastoma, Papillary tumour of the pineal region, Choroid plexus carcinoma, Glioma & glioblastoma, Primary CNS lymphoma, Medulloblastoma, Paediatric low-grade glioma, Diffuse midline glioma, H3 K27-altered (including DIPG), Atypical teratoid/rhabdoid tumour (ATRT), Ependymoma, Craniopharyngioma, Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma, Brain and spinal cord tumours (all types), Astrocytoma, IDH-mutant (grades 2 to 4), Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Paediatric high-grade glioma (excluding diffuse midline glioma), Meningioma, Brain metastases (secondary brain tumours), Vestibular schwannoma (acoustic neuroma), Central nervous system germ cell tumours (germinoma and non-germinomatous), Spinal cord tumours (intramedullary and intradural), WNT-activated medulloblastoma, SHH-activated medulloblastoma, Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)
Cabergoline (or bromocriptine), with attempted withdrawal after prolonged normalisation and shrinkage.
Transsphenoidal surgery; radiotherapy and temozolomide for aggressive or giant tumours as on the parent page.
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Query for this cancer: (TITLE:"Lactotroph pituitary neuroendocrine tumour" OR ABSTRACT:"Lactotroph pituitary neuroendocrine tumour" OR TITLE:"prolactinoma" OR ABSTRACT:"prolactinoma" OR TITLE:"Prolactinoma" OR ABSTRACT:"Prolactinoma" OR TITLE:"Lactotroph tumour" OR ABSTRACT:"Lactotroph tumour" OR TITLE:"Lactotroph tumour prolactinoma" OR ABSTRACT:"Lactotroph tumour prolactinoma" OR TITLE:"Prolactin-secreting pituitary adenoma" OR ABSTRACT:"Prolactin-secreting pituitary adenoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Lactotroph pituitary neuroendocrine tumour (prolactinoma), not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
Take on an empty stomach or at bedtime to reduce nausea; PJP prophylaxis during concurrent chemoradiation.
See all on the product pages:Temozolomide·Printable cards in the navigator
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