Loading
4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
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.
| Setting | Approach | Guideline |
|---|---|---|
| First line | Cabergoline (or bromocriptine), with attempted withdrawal after prolonged normalisation and shrinkage. | not mapped |
| Resistant, intolerant or aggressive | Transsphenoidal surgery; radiotherapy and temozolomide for aggressive or giant tumours as on the parent page. | not mapped |