Prolactinoma Signs & Symptoms – USMLE Exams

by / Thursday, 22 July 2010 / Published in Internal Medicine

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Prolactinoma

  • Prolactin-secreting tumor
  • Always think of this when there is visual disturbances

Signs and Symptoms:

Men:

  • Impotence
  • Decreased libido
  • Gynecomastia
  • Most often men also present with headache and visual disturbacnes

Women:

  • Amenorrhea
  • Galactorrhea
  • Both in the absence of pregnancy

Diagnosis:

  • Rule out pregnancy
  • Rule out drugs such as: Metoclopromide, Phenothiazines, and/or TCA
  • MRI to confirm presence of tumor

Treatment:

  • 1st line treatment is a dopamine agonist such as bromocriptine (most prolactinomas respond to DA agonists).  Most of the time a DA agonist is all that is needed to eliminate symptoms.
  • If medical therapy doesn’t work, surgical removal is done

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