Hx
Reproductive age-female with new amenorrhea
Sx (males & females)
Visual field defects
Headaches
Sx (in females)
Amenorrhea
Galactorrhea
Sx (in males)
Hypogonadism
Workup
Pelvic and breast exam
Urine hCG
Prolactin
LH/FSH
TSH
MRI-brain
Tx (for both micro- and macroprolactinomas) is primarily medical
Dopamine agonists (e.g. bromocriptine and cabergoline*)
*a new drug that is more effective and has fewer side-effects than bromocriptine
Medical tx results in
Normalization of PRL levels
Significant reduction in tumor size
Surgery may be required for patients that don't respond to medical therapy
Radiotherapy may be indicated for aggressive tumors that do not respond to medical and surgical therapy.
The response to radiotherapy is generally delayed, and there is a risk of development of panhypopituitarism.
See also: Pituitary tumors