Prolactinoma

People with prolactinoma may have one or more of the following symptoms:

1. Milky discharge from the breast
2. Enlargement of the breast tissue
3. Impaired vision (partial or completed vision loss in one of both eyes). This might be gradual or sudden.
4. Headache
5. Symptoms related to pituitary hormone deficiencies caused by the tumor – the most common being hypogonadism (symptoms due to low testosterone in males or estrogen in females). (insert a link to hypopituitarism)

Dr Reena Thomas will diagnose this condition with a comprehensive medical evaluation, thorough physical examination, and appropriate blood tests to check for all the pituitary gland hormones.

She will refer you to an ophthalmologist for a detailed ophthalmology evaluation to find out if there is any pituitary gland tumor compression of the structures in the brain.

She will also order appropriate radiology tests – including an MRI or CT scan of the pituitary gland. Getting the appropriate tests is important to diagnose the type of pituitary tumor and helps guide treatment strategies.

Treatment of a pituitary tumor is dependent on the size of the tumor, type of the pituitary tumor, excess hormone production, and pressure on the surrounding structures in the brain. Dr Reena Thomas will help guide the optimal treatment of this condition by starting you on the appropriate medication and or referring you to an experienced surgeon for the removal of the tumor. She will advise you of advanced therapeutic options in cases of aggressive tumors.

Medications

Prolactinoma is a tumor that is responsive to medications like Cabergoline and Bromocriptine and may not need surgery. These medications decrease the amount of prolactin production as well as decrease the size of pituitary gland tumors. Dr Thomas will help start you on the right medication, monitor the effect of the medication on the pituitary tumor, and help you with any side effects of the medications. At regular intervals, she will arrange for you to have radiological imaging like a CT scan/MRI of the pituitary gland to monitor the impact of the medication on the size of the tumor.

Surgery

If the prolactinoma is not responding to medications or is large and invading the surrounding structures in the brain and producing compressive symptoms of the surrounding structures in the brain, then you will need surgery.

Dr. Reena Thomas will refer you to an experienced neurosurgeon who will evaluate you and perform the removal of the pituitary tumor.

Chemotherapy

Chemotherapy – medications like temozolomide are used in aggressive tumors refractory to conventional treatment.

Radiation therapy

Suppose the tumor is large and is incompletely removed by surgery but is still producing either excess hormones or causing pressure on the surrounding structures in the brain. In that case, you may need radiation therapy. Radiation therapy helps with tumor growth control as well as in controlling the production of excess hormones from the pituitary gland.

Lifelong follow-up is required to monitor the complete resolution of the tumor hormone excess and the recurrence of the tumor. Dr Reena Thomas will perform a comprehensive evaluation, appropriate tests, and imaging needed to optimally monitor any recurrence of the tumor.