Prolactinopituitary tumors are usually seen in women and manifest as amenorrhea, lactation and infertility. However, men also have lactogen in their bodies and can have prolactinomas. The clinical manifestations of prolactinomas in men are very different from those in women, often manifesting as hypogonadism and, when the pituitary tumor is large and compresses the optic nerve, it can also cause vision loss and visual field loss.
Mr. Chen, who is in his thirties, found that his sexual function decreased 1 year ago, accompanied by chest pain and hair loss, and he realized that something might be wrong. A hospital examination revealed that the prolactin was considerably above the normal range, so further brain MRI was performed and a pituitary tumor was found. This led to the basic diagnosis of a prolactinomatous pituitary tumor, and these symptoms of Mr. Chen were caused by the excessive secretion of prolactin by this tumor. After 2 weeks of medication with bromocriptine, Mr. Chen’s prolactin gradually decreased and his symptoms were significantly reduced or disappeared, and a few months later the MRI also showed that the pituitary tumor had shrunk significantly. At present, Mr. Chen is almost symptom-free by adhering to the medication.
Bromocriptine is a commonly used drug in China for the treatment of prolactinoma. For most of the prolactinomas, the drug can reduce the level of prolactin in the body and also reduce the size of the prolactinoma, avoiding the trauma and risk of surgery. Although bromocriptine is effective for most prolactinomas, there are some prolactinomas that are not sensitive to drug therapy or where the patient cannot tolerate the side effects of bromocriptine, in which case surgery may be required. Most pituitary tumors can now be treated satisfactorily with neuroendoscopic removal of the pituitary tumor through a small incision in the nasal cavity.