Clinical and Radiological Characteristics of a Patient with a Pituitary Tumor of the Prolactinoma Type — Case Report

Abstract

Introduction. Prolactinoma is a benign tumor of the anterior lobe of the pituitary gland. It is the most common type of pituitary adenoma. In terms of size, micro- and macroprolactinomas are distinguished. Prolactinoma is mostly a benign tumor (>98%). Symptoms in hyperprolactinemia are the result of excess hormone and mass effect. Symptoms of the mass effect include headaches, visual disturbances and dizziness. Excess prolactin leads to infertility and “amenorrhea — galactorrhea” syndrome.

Aim. To increase general understanding and awareness of the symptoms, causes, and treatments of patients diagnosed with prolactinomas.

Case Report. A 54-year-old female patient was admitted to the department for diagnosis due to left-sided headaches occurring for 6 years. Magnetic resonance imaging (MRI) of the pituitary gland was performed, which showed a 20×10×17.5 mm lesion. Blood tests showed high PRL values of 272.0 ng/ml (N<23.3 ng/ml). The patient was treated conservatively with cabergoline, achieving normalization of PRL levels and a reduction in tumor dimensions on follow-up MRI examination.

Discussion. Drug treatment of the patient with cabergoline led to normalization of prolactin levels and reduction in the size of the pituitary adenoma. Conservative treatment of hyperprolactinemia in the course of a prolactinoma adenoma is many years.

Conclusions. Pituitary adenomas of the prolactinoma type respond well to conservative treatment with dopamine agonists. Pituitary tumors should be considered in the differential diagnosis in cases of headaches, and if menstrual disorders or irregular menses are additionally present, it is necessary to complete the diagnosis for hyperprolactinemia. (JNNN 2024;13(2):78–84)