Macroprolactinomas in Adolescents and Young Adults
DOI:
https://doi.org/10.18554/refacs.v12i4.7405Keywords:
Prolactinomas, Pituitary gland, Adolescent, Young adultAbstract
Objective: to evaluate the degree of response to treatment based on reduction in tumor size, normalization of prolactin levels, restoration of pituitary function, and evolution of the neuro-ophthalmological condition. Methods: quantitative-retrospective review of medical records of adolescents and young adults treated at the Neuroendocrinology outpatient clinic of a teaching hospital in the state of Minas Gerais, Brazil, from March of 1991 to March of 2023. The diagnosed cases of macroprolactinoma and giant prolactinoma were confirmed by laboratory and imaging tests and analyzed intragroup. Results: six medical records were included, and among the cases, three were male and three were female. Amenorrhea and headache were the most common complaints in women, and neuro-ophthalmological in boys. After treatment, there was a reduction in tumor size, a drop in prolactin levels, reestablishment of some hormonal axes in some cases, and partial clinical improvement of neuro-ophthalmological symptoms. Conclusion: early diagnosis of prolactinomas in adolescents and young adults is challenging. The approach to macroprolactinomas in this age group represents a crucial piece in the understanding and effective management of this complex endocrine condition. In-depth discussion of these giant prolactinomas is essential to inform more effective clinical practices and direct personalized therapeutic interventions.
References
Tirosh A, Shimon I. Management of macroprolactinomas. Clin Diabetes Endocrinol. [Internet]. 2015 [citado em 25 ago 2024]; 1:5. DOI: https://doi.org/10.1186/s40842-015-0006-4
Shimon I. Giant prolactinomas. Neuroendocrinology [Internet]. 2019 [citado em 25 ago 2024]; 109(1):51-6. DOI: https://doi.org/10.1159/000495184
Fernandes V, Santos MJ, Almeida R, Marques O. Ten-year follow-up of a giant prolactinoma. BMJ Case Rep. [Internet]. 2015 [citado em 25 ago 2024]; bcr2015212221. DOI: https://10.1136/bcr-2015-212221
Maiter D, Delgrange E. Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol. [Internet]. 2014 [citado em 25 ago 2024]; 170(6):R213-27. DOI: https://doi.org/10.1530/EJE-14-0013
Shrivastava RK, Arginteanu MS, King WA, Post KD. Giant prolactinomas: clinical management and long-term follow-up. J Neurosurg. [Internet]. 2002 [citado em 25 ago 2024]; 97(2):299-306. DOI: https://doi.org/10.3171/jns.2002.97.2.0299
Wildemberg LE, Fialho C, Gadelha MR. Prolactinomas. Nouv Presse Med. [Internet]. 2021 [citado em 25 ago 2024]; 50(4):104080. DOI: https://doi.org/10.1016/j.lpm.2021.104080
Fidelff HL, Boquete HR, Suárez MG, Azaretzky M. Prolactinoma in children and adolescents. Horm Res. [Internet]. 2009 [citado em 25 ago 2024]; 72(4):197-205. DOI: https://doi.org/10.1159/000236081
Pinto EM, Bronstein MD. Aspectos moleculares da tumorigênese hipofisária. Arq Bras Endocrinol Metab. [Internet]. 2008 [citado em 25 ago 2024]; 52(4):599-610. DOI: https://doi.org/10.1590/S0004-27302008000400005
Snyder PJ, Cooper DS, Martin KA. Causes of hyperprolactinemia. [Internet]. 2024 [citado em 20 nov 2024] UpToDate. Disponível em: https://www.uptodate.com/contents/causes-of-hyperprolactinemia?search=causes%20of%20hyperprolactinemia&source=search_result&selectedTitle=1%7e110&usage_type=default&display_rank=1
Snyder PJ, Cooper DS, Martin KA. Causes, presentation, and evaluation of sellar masses. [Internet]; 2024 [citado em 20 nov 2024]; UpToDate. Disponível em:
Fukuhara N, Nishiyama M, Iwasaki Y. Update in pathogenesis, diagnosis, and therapy of prolactinoma. Cancers [Internet]. 2022 [citado em 25 ago 2024]; 14(15):3604. DOI: https://doi.org/10.3390/cancers14153604
Maiter D, Delgrante E. Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol. [Internet]. 2014 [citado em 25 ago 2024]; 170(6):R213-R27. DOI: https://doi.org/10.1530/EJE-14-0013
Cozzi R, Ambrosio MR, Attanasio R, Battista C, Bozzao A, Caputo M, et al. Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors. Eur J Endocrinol. [Internet]. 2022 [citado em 25 ago 2024]; 186(3):P1-P33. DOI: https://doi.org/10.1530/EJE-21-0977
Fidelff HL, Boquete HR, Sequera A, Suárez M, Sobrado P, Giaccio A. Peripubertal prolactinomas: clinical presentation and long-term outcome with different therapeutic approaches. J Pediatr Endocrinol Metab. [Internet]. 2000 [citado em 25 ago 2024]; 13(3):261-7. DOI: https://doi.org/10.1515/JPEM.2000.13.3.261
Auriemma RS, Pirchio R, Pivonello C, Garifalos F, Colao AM, Pivonelli R. Approach to the patiente with prolactinoma. J Clin Endocrinol Metab. [Internet]. 2023 [citado em 25 ago 2024]; 108(9):2400-23. DOI: https://doi.org/10.1210/clinem/dgad174
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