Endocrine Abstracts

Introduction: Prolactinomas are more invasive in males. Giant (≥4 cm) and huge (≥6 cm) ones are relatively rare in literature, but in our population they are nearly common.

Aim: We have taken our 20 last cases to analyze their radiological aspects, and their endocrine, neurological and ophthalmological complications.

Methods: All of them had clinical exam, hormonal, ophthalmological, and radiological exploration based on cerebral MRI. Mixed adenomas were excluded. Positive diagnosis was based on clinical presentation, high prolactin concentration, positive response to dopamine agonists ± immunohistochemy study.

Results: Mean age=42.45 years, mean tumor height=50.12 (40–70) mm and mean volume=48.6 mm³ (15.5–184). Mean prolactin=3199±5437 ng/ml. Solid and kystic aspect, with or without calcifications, is observed in more than 50%. Cavernous sinuses are invaded in all except one. Other invasions are (parietal or frontal lobe: 9, posterior invasion=9, anterior invasion=9 (with orbital infiltration in 1case), ethmoidal invasion=3. For endocrine complications we observed gonadic deficit in 78.9% cases, corticotrop and thyreotro insufficiencies were seen in respectively 35%, and 15.7%. Only 7 subjects had two or more pituitary deficits. Neurological and ophthalmological complications are as follows: the total loss of one or both eyes: 13, hydrocephaly: 2 cases, epilepsy: 2, conscious troubles or memory loss: 2, ptosis: 3, diplopia with or without strabismus: 2.

Conclusion: In this study concerning giant and huge male prolactinomas the total loss of one or both eyes is the most frequent abnormality (13/20). Severe neurological troubles are relatively frequent as they were observed in nearly one from 3 patients. But, multi pituitary deficits (7 cases) and active hydrocephaly (2 cases) are relatively rare, which argues for a low progression.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.