Hyperprolactinemia and Prolactinoma

The cause of prolactinoma are unknown. This tumor most commonly develops in individuals under the age of 40. It is significantly more common in women than men, and is very rare in children. 

Hyperprolactinemia, if not caused by prolactinoma, can also develop due to: 

If the tumor grows, it may place pressure on the brain and cause: 

Prolactinoma in women may cause:

Prolactinoma in men may cause:

If you develop signs or symptoms associated with prolactinoma and/or hyperprolactinemia, make an appointment to see your doctor.

During your appointment, your doctor will ask you questions regarding your symptoms and will perform a physical examination. If your doctor suspects hyperprolactinemia, he/she will prescribe a blood test in order to measure the amount of prolactin in the blood. This test will also analyze the levels of other hormones produced by the pituitary gland and will allow your doctor to check for other possible causes of your symptoms. 

An MRI scan or a CT scan may be used to detect a possible tumor in the pituitary gland.  Your doctor may request that you get a vision test to determine if the tumor is affecting your eyesight. 

Diagnosing hyperprolactinemia and/or prolactinoma may take some time, and you may be referred to different types of doctors, such as an endocrinologist and/or an oncologist, in order to determine an accurate diagnosis. 

Treatment for hyperprolactinemia will be determined based on the cause of the condition. If excess prolactin does not cause any symptoms, then treatment may not be necessary. Treatment options for hyperprolactinemia caused by prolactinoma include:

When medications are not effective, or if the tumor is affecting vision, surgical intervention may be required to remove the prolactinoma. 

The type of surgery performed will depend on the size, extent, and location of the tumor. The tumor can be removed using one of two techniques: 

Achieving the best outcome from hyperprolactinemia treatment requires a comprehensive, multidisciplinary approach that involves a highly skilled team of experts. MedStar Washington Hospital Center is the only multidisciplinary pituitary center of its kind in the Washington, D.C., area.

“We are proud to have over 50 years of combined expertise and more pituitary surgeries than any other hospital in the region." Dr. Edward Fiore Aulisi, Chairman of the Department of Neurosurgery and Medical Director of the The Pituitary Center at MedStar Washington Hospital Center.  

The pituitary center at MedStar Washington allows patients to schedule office visits, diagnostic testing, and surgery with a team of neurosurgeons experienced with pituitary disorders, a pituitary endocrinologist, a neuro ophthalmologist, and an otolaryngologist—all in the same location.

Prolactin levels before surgery will most likely indicate the likelihood that the hyperprolactinemia will resolve after removal of the tumor. The higher prolactin levels are, the less likely it is that they will return to normal after surgery.

If surgical intervention is required, prognosis typically depends on the size and location of the tumor. If the tumor is small, surgery typically corrects the accompanying hyperprolactinemia. However, many prolactinoma tumors return within five years of surgery. For this reason, it is extremely important to schedule and attend all follow-up appointments recommended by the physician in order to monitor for prolactinoma recurrence.