Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors

Cozzi, Renato; Ambrosio, Maria Rosaria; Attanasio, Roberto; Battista, Claudia; Bozzao, Alessandro; Caputo, Marco; Ciccarelli, Enrica; Marinis, Laura De; Menis, Ernesto De; Faustini‐Fustini, Marco; Grimaldi, Franco; Lania, Andrea; Lasio, Giovanni; Logoluso, Francesco; Losa, Marco; Maffei, Pietro; Milani, Davide; Poggi, Maurizio; Zini, Michele; Katznelson, Laurence; Luger, Anton; Poiană, Cătălina

doi:10.1530/eje-21-0977

Cited by 34 publications

(30 citation statements)

References 237 publications

(443 reference statements)

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“…Many studies revealed that those patients with high prolactin levels reported the absence of their menstrual period. When the level of milk hormone rises, this causes inhibition of the main hormones, FSH and LH, in the occurrence of a regular menstrual cycle, and one of its symptoms is the exit of milk from the breast outside the lactation period [13,14].…”

Section: Resultsmentioning

confidence: 99%

Assessment of the Pituitary Gland by MRI in Patients with Different Prolactin Levels in Hail Region

Elamin¹,

Qaba²,

Alshammry³

et al. 2023

Int J Pharm Res Allied Sci

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The pituitary gland is considered the maestro gland that regulates the function of all glands. Magnetic resonance imaging (MRI) is a routine and widely accepted method for investigating pituitary gland abnormalities. This study was performed to assess the pituitary gland by MRI in patients with different prolactin levels in Hail Region, Saudi Arabia. The data of this study were collected retrospectively from a patient with a pituitary MRI from the radiology department and a prolactin test from a laboratory in the King Khalid Hospital in Hail Region, in the period from January 2022 to June 2022. The sample of this study consisted of 102 patients with prolactin tests from both genders who were examined by MRI for the Pituitary and their ages ranged from 18 to 60 years old. They were from Hail Region. The results of this study showed that female patients from 31-40 years old have more chance of hyperprolactinemia diseases. Hyperprolactinemia is a common condition among women of reproductive age rather than males. The largest percentage according to Gender was in favor of females with a rate of 74 and a percentage of (72.5%), followed by males with a rate of 28 and a percentage of (27.50%). The study concluded that the high prolactin level be evaluated using MRI to assess the pituitary gland size and tumor, and the result can be investigated and compared with the previous study if it is found.

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Section: Resultsmentioning

confidence: 99%

Assessment of the Pituitary Gland by MRI in Patients with Different Prolactin Levels in Hail Region

Elamin¹,

Qaba²,

Alshammry³

et al. 2023

Int J Pharm Res Allied Sci

View full text Add to dashboard Cite

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“…Furthermore, they are usually indicated in case of persistent or recurrent disease after surgery or when this is contraindicated or not feasible (10,18). All the patients undergoing radiotherapy presented panhypopituitarism requiring replacement hormone treatment, while in literature this is observed in 25% of patients undergoing this treatment, especially if the dose is greater than 8-10Gy (10,11,14).…”

Section: Discussionmentioning

confidence: 99%

Pituitary Macroadenomas in Childhood and Adolescence: A Clinical Analysis of 7 Patients

Aguilar-Riera

Clemente

Gonzalez-Llorens

et al. 2023

Preprint

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BACKGROUND Pituitary adenomas (PPAs) are uncommon in childhood and adolescence, accounting for 2-6% of all intracranial neoplasms. Delayed puberty, growth retardation, galactorrhea and weight gain are common features at presentation in pediatric patients. Functional tumors constitute a vast majority (90%) of PPAs, with the most frequent being prolactinomas. CASE PRESENTATION A retrospective review of the clinical features and outcomes of 7 pediatric patients with pituitary macroadenomas was conducted. We included PPAs in patients under 18 years at diagnosis with diameters larger than 10mm by magnetic resonance (MRI). Six patients were males (85%), with age at diagnosis ranging from 8 to 15 (median 14+/2.8SDS). The primary symptoms that led to medical attention were growth retardation, gigantism and secondary amenorrhea. The visual field was reduced in three cases (42%). Suprasellar extension was present in 3 subjects, and one had a giant adenoma. Adenomas were clinically functioning in 6 patients (85%) (three prolactinomas, two somatropinomas, one secreting FSH and one no-producer). The prolactinomas responded to treatment with cabergoline. For the rest, one required transsphenoidal surgery and the other three both surgery and radiotherapy. All patients undergoing radiotherapy had secondary panhypopituitarism. In relation to the genetic studies, two patients presented a pathogenic mutation of the AIP gene and one of the MEN1. DISCUSION AND CONCLUSION Pediatric pituitary macroadenomas are a distinct entity, mostly found in males and with a predominance of functional tumors leading to detrimental effects on growth and puberty in addition to neuro-ophthalmological manifestations. It is important to perform genetic studies in patients with macroadenomas appearing under the age of 30 years as genetic and syndromic associations are more frequent in this age group.

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“…For patients with prolactinoma with drug intolerance or resistance, surgery is the next step in the treatment algorithm. Based on recent evidence, surgery is now increasingly considered as a first line treatment option for microprolactinomas and circumscribed macroprolactinomas in which complete resection can be anticipated [2,5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. With more elective cases being considered for surgery, it becomes more clinically relevant to reliably identify the precise localization of the (remnant) lesion, possible multifocality, and its potential invasion in surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

Implementation of functional imaging using 11C-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery

et al. 2022

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Purpose To report the first experience of our multidisciplinary team with functional imaging using 11C-methionine positron emission tomography-computed tomography (11C-methionine PET-CT) co-registered with MRI (Met-PET/MRICR) in clinical decision making and surgical planning of patients with difficult to treat prolactinoma. Methods In eighteen patients with prolactinoma, referred to our tertiary referral centre because of intolerance or resistance for dopamine agonists (DA), Met-PET/MRICR was used to aid decision-making regarding therapy. Results Met-PET/MRICR was positive in 94% of the patients. MRI and Met-PET/MRICR findings were completely concordant in five patients, partially concordant in nine patients, and non-concordant in four patients. In five patients Met-PET/MRICR identified lesion(s) that were retrospectively also visible on MRI. Met-PET/MRICR was false negative in one patient, with a cystic adenoma on conventional MRI. Thirteen patients underwent transsphenoidal surgery, with nine achieving full biochemical remission, two clinical improvement and near normalized prolactin levels, and one patient clinical improvement with significant tumour reduction. Hence, nearly all patients (94%) were considered to have a positive outcome. Permanent complication rate was low. Three patients continued DA, two patients have a wait and scan policy. Conclusion Met-PET/MRICR can provide additional information to guide multidisciplinary preoperative and intraoperative decision making in selected cases of prolactinoma. This approach resulted in a high remission rate with a low rate of complications in our expert centre.

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Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors

Cited by 34 publications

References 237 publications

Assessment of the Pituitary Gland by MRI in Patients with Different Prolactin Levels in Hail Region

Assessment of the Pituitary Gland by MRI in Patients with Different Prolactin Levels in Hail Region

Pituitary Macroadenomas in Childhood and Adolescence: A Clinical Analysis of 7 Patients

Implementation of functional imaging using 11C-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery

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