Chủ Nhật, 12 tháng 1, 2014

Prolactinoma

Prolactinoma Prolactin is the hormone produced by women who are breastfeeding. It is a natural hormone released during the time of childbirth and will continue till the mother involves in lactating the child. Prolactin hormone stimulates the breast tissues to secrete milk. The level of prolactin will be high as long as the mother breastfeeds the child. Prolactinoma is harmless tumor found on the pituitary gland.


During this condition excess of prolactin hormone is produced from the tumor and released into the bloodstream. Prolactinoma is a common type of pituitary tumor which is marked by over production of prolactin. Prolactinoma can be treated and managed effectively through medications so that prolactin is reduced to normal level. In rare cases, pituitary tumor is removed through surgery.


Symptoms :


Very often there is no symptom for prolactinoma. Signs are produced only when the prolactin level is high in blood and the tumor grows larger in size exerting pressure on the surrounding tissues. Some of the common symptoms of prolactinoma are reduced hormone secretion of reproductive glands.


It can cause milky discharge from breasts even when the mother is not breastfeeding. Irregular menstrual cycle or lack of monthly periods is one of the signs of prolactinoma. For some women it can cause vaginal dryness leading to pain during intercourse. Women may develop excess of body hair on face and other private parts. In males prolactinoma can cause infertility problems like erectile dysfunction and enlarged breasts. Overall he will lose interest in sexual activity due to reduced sex hormone. In rare cases it can cause blurred vision, headache and low bone density.


Causes :


Exact cause of prolactinoma is not known though speculations are there it is caused due to abnormality in cell growth. Some people may get this problem due to genetic disorder like multiple endocrine neoplasia and they will have high chance of getting peptic ulcer. It is believed to be inherited by birth if the person has family history of pituitary gland tumor. Overproduction of prolactin hormone can be caused due to certain medications, due to underactive thyroid gland and pregnancy or breastfeeding stage.


Complications :


Prolactinoma can impair the normal vision by compressing the optical nerve. It can cause abnormality and dysfunction in the production of other hormones of pituitary gland. In some cases it can cause osteoporosis due to reduced bone density. A woman who becomes pregnant with prolactinoma can get affected due to additional secretion of prolactin hormone causing intense headache and blurred vision.


Tests :


Your doctor will order for blood culture for detecting the overproduction of prolactin. A complete blood profile will give clear picture of normal levels of other hormone also. Sometimes your doctor may order for imaging tests like CT scan or MRI scan of brain to find out how far the tumor has developed.


Treatment :


The main purpose of treating prolactinoma is to reduce the size of tumor and regularize the secretion of prolactin hormone to normal level. The treatment method should also ensure normal function of pituitary gland in future. Medications and surgery are two options of treatment for prolactinoma. Oral pills are given for decreasing the prolactin secretion and to give relief from the above symptoms. Medications are effective in reducing the tumor size but you have to continue taking medications for long term.


Dopamine agonists like bromocriptine, and cabergoline are effective in shrinking the tumor and decreasing the level of prolactin secretion. For pregnant women bromocriptine is the best possible safe drug for treating prolactinoma complications. However you have to consult your doctor about the possible side effects before getting pregnant with this problem. Bromocriptine is known to produce side effects like nausea and lightheadedness. But these are minimal side effects and not seen in all people who take this drug.


Drugs like cabergoline may produce adverse effect like heart valve leakage and compulsive behavior in some cases. Surgical intervention is needed only if the medications are not effective in stopping the prolactin secretion and the pituitary tumor is excessively large in size causing pressure on the neighborhood nerves. Trans-sphenoidal surgery is the procedure in which the tumor is removed gently through nasal cavity without causing any damage to the brain. In transcranial process, craniotomy is to be done for opening the skull and removing tumor. In most of the cases surgery will provide relief from symptoms. But in some cases, pituitary tumors recur even after surgery. Radiation therapy is also done for shrinking the tumor.


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