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Macroprolactinoma

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • prolactinoma is the most common form of pituitary tumour accounting for approximately 50% of pituitary adenomas
  • commonly diagnosed when raised prolactin levels are found during investigation of secondary amenorrhoea or galactorrhoea
  • alternative causes of raised prolactin levels includes pregnancy, hypothyroidism and drugs e.g. antipsychotics, anti-emetics
  • prolactinomas may occur as part of the MEN-1 syndrome
  • pituitary tumours are classified according to size - microadenomas (<1cm) and macroadenomas - prolactinomas are considered in terms of microprolactinomas and macroprolactinomas

Note that non-secretory pituitary adenomas may also cause hyperprolactinaemia - this may occur if a non-secretory adenoma disrupts the flow of hypothalmic dopamine (the physiological prolactin inhibitory factor) to the lactotrophs (the pituitary cells which produce prolactin).

  • giant prolactinomas, a rare subtype of macroadenomas, are characterized by large size (over 4 cm), very high prolactin levels (more than 1000 ng/ml) and invasive growth and are thus the most difficult to treat

Reference:

  • Melmed S, Casanueva FF, Hoffman AR, et al.Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96: 273-288.

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