Endocrine Abstracts

Introduction: Prolactinoma is the commonest pituitary adenoma. The aim of this study was to compare clinical, biological and radiological characteristics in microprolactinoma and macroprolactinoma.

Patients: This retrospective study included 33 patients with prolactinoma. The tumor was a microadenoma (<1 cm) in 27.3% (n=9) and a macroadenoma in 72.7% (n=24) of cases.

Results: Patients were female in 84.8% of cases (n=28). Mean age at diagnosis was 37 years (ext: 20–78). Diagnostic circumstances were symptoms related to hyperprolactinemia in 54.5% (n=18), and tumoral syndrome in 45.5% (n=15) of cases. The first complaint was tumoral syndrome in 30.4% (n=7) of patients. Mean progression period was 44.38 months (ext: 0.2–264). Mean serum prolactin level was 4488.35 ng/ml (ext: 31.9–76 915). Mean size of adenoma on MRI was 20.93 mm (ext: 5–60). Comparing microadenoma and macroadenoma revealed that macroadenoma was associated with a higher diagnostic age (39.29 vs 30.89 years) but a shorter progression period (39.381 vs 62.4 months). Tumoral syndrome was present in 58% of macroprolactinomas and in only one case of microprolactinoma while signs of hyperprolactinemia were observed in respectively 58 and 89% of cases. Mean prolactinemia was 5956.40 and 84.18 ng/ml respectively in macroprolactinoma and microprolactinoma. In macroprolactinoma, hemorrhage signs on MRI were present in 37% (n=9), cavernous sinus extension in 29% (n=7), sphenoidal extension in 17% (n=4) and chiasmatic invasion in 12.5% of cases; while a single case of sphenoidal invasion was found in microprolactinomas. Thyreotropic and corticotropic deficiencies were found in 17 and 12.5% of macroprolactinomas.

Conclusion: These results are particular by the relative high frequency of macroprolactinoma. Tumoral syndrome is the commonest symptom in macroprolactinoma. A shorter time to diagnosis in macroprolactinoma suggests the important impact of this complaint on patients motivating them to consult.