Endocrine Abstracts

Introduction: Male prolactinomas are very rare pituitary tumors as they account for 1/10 among pituitary tumors secreting prolactin. They are usually larger and more aggressive than female ones. The gonadal deficit due to multi factorial mechanism is well known, but other deficiencies are diversely appreciated. Our aim was to analyze anterior and posterior pituitary functions in a large series of male prolactinomas.

Subjects and methods: 117 male prolactinomas were analyzed. Their median age was 37.9±13 years (15–79), median prolactin=4558±8039 ng/ml (67–34 858), median tumor height=40.2±22.9 mm (3–13). 42.7% were giant (≥4 cm) and 71% were invasive (invasion of one or both cavernous sinuses). Apart from prolactin, all had hormonal assessment based on cortisol and ACTH, testosterone, FSH and LH, GH ± IGF1, TSH and thyroxin (free T₄), and posterior pituitary exploration based on 24 h urine quantification and urine specific gravity.

Results: 0.85% (n=1) had posterior pituitary deficit, 80.7% had gonadal deficit and 75% had two or more anterior pituitary deficits.

Conclusion: In this large series of male prolactinomas, posterior pituitary deficit is exceptional (<1%), but anterior pituitary deficiencies are very common because of giant and or invasive tumors.