Materiały źródłowe

• #1 Prolactinoma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/124634-overview

  Prolactinomas, benign lesions that produce the hormone prolactin, are the most common hormone-secreting pituitary tumors. […] The exact frequency with which prolactinomas occur in the general population is not clearly established. In nonselected surgical series, this tumor accounts for approximately 25-30% of all pituitary adenomas. Some growth hormone (GH) producing tumors also cosecrete PRL. Microprolactinomas are much more common than macroprolactinomas. […] In a study of 81,449 inhabitants of Banbury, Oxfordshire, in the United Kingdom, Fernandez et al determined the incidence of pituitary adenomas there to be 77.6 cases per 100,000 population, with the majority of cases (57%, or 44.4 persons per 100,000 population) being prolactinomas. […] It was also determined that prolactinomas accounted for most pituitary adenomas in persons up to age 60 years, the incidence being 75% of pituitary adenomas occurring in persons up to age 20 years, and 61% of pituitary adenomas in persons between the ages of 20 and 60 years.

• #2 Prolactinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459347/

  Prolactinomas account for up to 40% of all clinically recognized pituitary adenomas. The mean prevalence of prolactinoma is estimated to be approximately 10 per 100,000 in men and 30 per 100,000 in women, with a peak prevalence in women aged 25 to 34 years. Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. […] Prolactin-secreting tumors of the pituitary gland, also known as prolactinomas, are the most common secretory tumors of the pituitary gland, accounting for up to 40 percent of pituitary adenomas.

• #3 Update in Pathogenesis, Diagnosis, and Therapy of Prolactinoma

  https://www.mdpi.com/2072-6694/14/15/3604

  Prolactinoma accounts for approximately 50% of all pituitary tumors and is the most frequent of all functional PitNETs. The annual incidence of prolactinomas is about 2.2 per 100,000 in Finland. It is most common in women of reproductive age, with an incidence of about 10 per 100,000. Peak incidence occurs around 30 years old but is also seen after menopause. The annual incidence of DA-treated hyperprolactinemia is 24 per 100,000 women aged 25 to 34 in the Netherlands. Male patients are relatively rare, and the disease takes longer to be diagnosed because of the lack of clinical symptoms. […] Prolactinomas are common pituitary neuroendocrine tumors (PitNET) derived from prolactin (PRL)-producing cells that cause hypogonadism and infertility due to hyperprolactinemia. It most frequently occurs in young women and is often associated with galactorrhea and amenorrhea. Most cases are sporadic, but prolactinomas may also occur because of mutations of the multiple endocrine neoplasia type 1 (MEN1) or aryl hydrocarbon receptor-interacting protein (AIP) gene. Medical therapy with a dopamine agonist (DA) is highly effective in the majority of cases.

• #4 Prolactinoma: Early Detection, Evaluation and Management – The ObG Project

  https://www.obgproject.com/2017/04/18/prolactinoma-early-detection-evaluation-and-management/

  Prolactinomas are generally benign prolactin-secreting tumors and account for 40-66% of all pituitary adenomas. The vast majority are microadenomas (diameter < 1cm) and suppress the hypothalamic-pituitary gonadal hormonal axis, while 10% are macroadenomas (≥ 1cm) and may cause additional mass effects due to size. Age prevalence varies widely, but they are commonly found in women during childbearing years, in part due to development of menstrual irregularities. Despite their benign nature, if diagnosis is delayed bone loss and vertebral fractures can occur, and the loss of bone density can be permanent. [...] The prevalence of prolactinomas is reported to be between 35 to 50 per 100,000. They are most commonly seen in women (10:1 ratio female/male) and the usual age range is between 20 to 50 years of age.

• #5 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #6 Treatment of Prolactinoma

  https://www.mdpi.com/1648-9144/58/8/1095

  Prolactinomas are the commonest pituitary neuroendocrine tumor (PitNET), with a recent epidemiological review estimating that this tumor subtype makes up 53% of PitNETs. […] The pathway to diagnosis of prolactinoma may be via hormonal investigation of symptoms of reproductive dysfunction such as menstrual disturbance and galactorrhea in females or erectile dysfunction, loss of libido, and rarely galactorrhea in males. […] Natural history studies of patients with microprolactinomas have demonstrated that they rarely increase in size, even if left untreated. […] Prolactinomas are less common in men overall, but the proportion of macroadenomas, particularly large, invasive tumors is higher. […] Prolactinomas may present as part of a genetic syndrome such as multiple endocrine neoplasia type 1 (MEN1) or type 4 (MEN4), Succinate dehydrogenase (SDHx) mutations, and aryl hydrocarbon receptor interacting protein (AIP)-associated familial pituitary adenoma syndrome (FIPA).

• #7 The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31326373/

  Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. […] DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. […] Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. […] Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.

• #8 Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2021.1000

  Only a few studies have established the epidemiology of prolactinoma and Cushings disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushings disease and their survival analysis according to treatment. […] The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushings disease. […] Overall, the incidence of prolactinoma and Cushings disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. […] The incidence of prolactinomas was 23.5 cases per million, and its prevalence was 82.5 cases per million. The incidence of CD was 2.3 cases per million, and its prevalence was 9.8 cases per million.

• #9 Prolactinoma epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Prolactinoma_epidemiology_and_demographics

  About 45% of pituitary adenomas are prolactinomas, making it the most common type of all pituitary adenomas. Worldwide, the prevalence of sporadic prolactinoma is 6 to 10 per 100,000 persons. The prevalence of prolactinoma in people less than 20 years old is 10 per 100,000 individuals worldwide. Prolactinoma most commonly affects women in reproductive age group (20 to 50 years). Prolactinoma is more common in females than males in people between 20 and 50 years old. Distribution among males and females becomes similar after age 50. […] Worldwide, the prevalence of sporadic prolactinoma ranges from a low of 6 persons per 100,000 persons to a high of 10 persons per 100,000 persons. […] Worldwide, the prevalence of prolactinoma in people less than 20 years old is 10 individuals per 100,000 individuals.

• #10 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  Prolactinoma affects both females and males, having an incidence of 3-5 cases/100,000 individuals/year and a general prevalence of 50 cases/100,000 individuals which is higher in subjects with hypogonadism since increased prolactin levels induce central inhibition of gonadotropes through kisspeptin neurons. […] The detection of APRLs may not start from the clinical presentation itself, but the imaging detection of a large pituitary mass in addition to large mass-associated symptoms and signs and extremely elevated prolactin levels are important clues, further followed by a poor response to DA medication and need for neurosurgery/early relapse after hypophysectomy due to the unusual rapid growth. […] Generally, a patient with prolactinoma becomes a neurosurgery candidate in the event apoplexy or cystic transformation is present, neurological/ophthalmic deficit has been identified, and the patient develops DA resistance or intolerance.

• #11

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2024/08000/prolactinoma__navigating_the_dual_challenge_of.48.aspx

  Prolactinoma is the most common secretory tumour of the pituitary gland, accounting for up to 40% of all pituitary adenomas. Both males and females are affected by prolactinoma, which has a general prevalence of 50 cases per 100,000 people and an incidence of 35 cases per 100,000 people per year. […] Prolactinomas rank as one of the most prevalent tumours of the pituitary gland, accounting for ~40% of all pituitary adenomas. It exhibits a higher incidence among females, primarily affecting women aged 20-50. However, beyond age 50, its occurrence becomes equally distributed between genders. […] Prolactinomas are notorious for the vast effects they have throughout multiple organ systems. […] Prolactinomas, the most common type of pituitary adenomas, often require pharmacological intervention to regulate hormone levels.

• #12 Orphanet: Prolactinoma

  https://www.orpha.net/en/disease/detail/2965

  In Europe, the prevalence of prolactinoma is reported at between 1/1,600-2,200 (Belgium, UK and Switzerland). A notable female preponderance is observed, particularly among premenopausal women. Prolactinoma accounts for 66% of clinically relevant pituitary adenomas. […] Prolactinomas usually occur sporadically and with the exception of prolactinoma due to MEN1 or FIPA, the occurrence of prolactinomas as part of inherited syndromes is exceptionally rare. In patients with a pathogenic variant of AIP, the inheritance is autosomal dominant and thus offspring of an affected individual have a 50% risk of inheriting the mutation; however, penetrance is variable.

• #13 The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31326373/

  Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. […] DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. […] Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. […] Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.

• #14 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  Prolactinoma affects both females and males, having an incidence of 3-5 cases/100,000 individuals/year and a general prevalence of 50 cases/100,000 individuals which is higher in subjects with hypogonadism since increased prolactin levels induce central inhibition of gonadotropes through kisspeptin neurons. […] The detection of APRLs may not start from the clinical presentation itself, but the imaging detection of a large pituitary mass in addition to large mass-associated symptoms and signs and extremely elevated prolactin levels are important clues, further followed by a poor response to DA medication and need for neurosurgery/early relapse after hypophysectomy due to the unusual rapid growth. […] Generally, a patient with prolactinoma becomes a neurosurgery candidate in the event apoplexy or cystic transformation is present, neurological/ophthalmic deficit has been identified, and the patient develops DA resistance or intolerance.

• #15 Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2021.1000

  Only a few studies have established the epidemiology of prolactinoma and Cushings disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushings disease and their survival analysis according to treatment. […] The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushings disease. […] Overall, the incidence of prolactinoma and Cushings disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. […] The incidence of prolactinomas was 23.5 cases per million, and its prevalence was 82.5 cases per million. The incidence of CD was 2.3 cases per million, and its prevalence was 9.8 cases per million.

• #16 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #17 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Pituitary adenomas (PAs) are defined as benign monoclonal tumors in the pituitary gland that cause symptoms due to either hormonal hypersecretion or a space-occupying effect, and are classified as functioning or non-functioning. […] Considering their public health impact and association with increased morbidity and mortality, however, it is essential to understand the prevalence and incidence of PAs in order to improve patient outcomes and to minimize the resultant burden on the health care system. […] PAs were previously considered to be very rare, but recent data have revealed that their prevalence is higher than previously reported, potentially due to developments in imaging techniques and the increased detection of incidentalomas found during radiological work-ups for other diseases.

• #18 Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016 | Scientific Reports

  https://www.nature.com/articles/s41598-021-94658-8

  The overall standardized incidence rate was 4.8 cases per 100,000 person-years over 13 years of surveillance. […] The annual incidence rate continually trended upwards, with a peak seen in 2015 (5.8 cases per 100,000 person-years). […] A bimodal age-related distribution was observed in female patients, with a first peak seen in adults aged 25-34 years and a second peak in the elderly aged 60-69 years. […] The rising incidence might be related to the significant advancements in neuroimaging, a higher incidentally discovered rate or the increased awareness of pituitary diseases among physicians. […] The SEER database is widely recognized to be among the most reliable resources in reporting epidemiologic features and survival data for various neoplasms. […] The present study found that the annual incidence is increasing and revealed additional factors that associated with overall survival in all histology types with a longer surveillance period. […] More than 80% of the patients survived 10 years and younger age at diagnosis, smaller tumor size, and typical adenoma are associated with prolonged overall survival.

• #19 Prolactinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459347/

  Prolactinomas account for up to 40% of all clinically recognized pituitary adenomas. The mean prevalence of prolactinoma is estimated to be approximately 10 per 100,000 in men and 30 per 100,000 in women, with a peak prevalence in women aged 25 to 34 years. Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. […] Prolactin-secreting tumors of the pituitary gland, also known as prolactinomas, are the most common secretory tumors of the pituitary gland, accounting for up to 40 percent of pituitary adenomas.

• #20 Review of Clinical Recommendations on Prolactinoma and Pregnancy

  https://www.endocrinolrespract.org/en/review-of-clinical-recommendations-on-prolactinoma-and-pregnancy-13333

  Prolactinomas are the most common hormone-secreting pituitary adenomas. Prolactinomas account for nearly 3040 percent of all the pituitary adenomas. Although it affects individuals over a wide age range, it is more common in 2040-year-old female patients, who are in their reproductive age. Prolactinomas may cause hypogonadism, menstrual cycle dysfunction (oligomenorrhea or amenorrhea) and infertility (luteal phase abnormalities or anovulation) in premenopausal women. […] When pregnancy is excluded, hyperprolactinemia in approximately 10 to 20 percent of the patients results in amenorrhea. Women with untreated prolactinomas are generally unable to achieve pregnancy, as the hyperprolactinemia affects the pulsatility of gonadotropin-releasing hormone (GnRH) and diminishes follicle-stimulating hormone (FSH) as well as luteinizing hormone (LH) secretion. The sum of these effects induces amenorrhea, infertility, and hypogonadism, thereby posing difficulties in fertility. Therefore, in most women prolactinoma is diagnosed prior to conception. However, ovulation and fertility usually improve after proper diagnosis and treatment of prolactinoma. Therefore, during the surveillance of these patients, the onset of pregnancy is a common phenomenon. Management of these pregnancies may sometimes be challenging and require a multidisciplinary approach involving an endocrinologist, a gynecologist, a radiologist and an experienced neurosurgeon in order to achieve the best outcomes both for the patient as well the infant.

• #21 Prolactinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459347/

  Prolactinomas account for up to 40% of all clinically recognized pituitary adenomas. The mean prevalence of prolactinoma is estimated to be approximately 10 per 100,000 in men and 30 per 100,000 in women, with a peak prevalence in women aged 25 to 34 years. Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. […] Prolactin-secreting tumors of the pituitary gland, also known as prolactinomas, are the most common secretory tumors of the pituitary gland, accounting for up to 40 percent of pituitary adenomas.

• #22

  https://step1.medbullets.com/endocrine/109063/prolactinoma

  most common pituitary adenoma (40% of all pituitary adenomas) […] more common in women than men […] peak prevalence in women ages 25-34 years […] lateral parts of anterior pituitary are most common sites

• #23 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #24 Prolactinoma epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Prolactinoma_epidemiology_and_demographics

  Prolactinoma commonly affects individuals between 20 and 50 years old. […] Women are more commonly affected by prolactinoma than men. The female to male ratio is approximately 10:1. […] Women aged 20 to 30 years have the highest prevalence of prolactinoma, with a female to male ratio of approximately 14:1. […] Men and women are affected equally after age 50 years. The prevalence of prolactinoma increases with age in men after age 50 and peaks during ages 60 to 70 years. At this time, the female to male ratio is 1:3.

• #25 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #26 Prolactinoma epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Prolactinoma_epidemiology_and_demographics

  Prolactinoma commonly affects individuals between 20 and 50 years old. […] Women are more commonly affected by prolactinoma than men. The female to male ratio is approximately 10:1. […] Women aged 20 to 30 years have the highest prevalence of prolactinoma, with a female to male ratio of approximately 14:1. […] Men and women are affected equally after age 50 years. The prevalence of prolactinoma increases with age in men after age 50 and peaks during ages 60 to 70 years. At this time, the female to male ratio is 1:3.

• #27

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2024/08000/prolactinoma__navigating_the_dual_challenge_of.48.aspx

  Prolactinoma is the most common secretory tumour of the pituitary gland, accounting for up to 40% of all pituitary adenomas. Both males and females are affected by prolactinoma, which has a general prevalence of 50 cases per 100,000 people and an incidence of 35 cases per 100,000 people per year. […] Prolactinomas rank as one of the most prevalent tumours of the pituitary gland, accounting for ~40% of all pituitary adenomas. It exhibits a higher incidence among females, primarily affecting women aged 20-50. However, beyond age 50, its occurrence becomes equally distributed between genders. […] Prolactinomas are notorious for the vast effects they have throughout multiple organ systems. […] Prolactinomas, the most common type of pituitary adenomas, often require pharmacological intervention to regulate hormone levels.

• #28 Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016 | Scientific Reports

  https://www.nature.com/articles/s41598-021-94658-8

  The overall standardized incidence rate was 4.8 cases per 100,000 person-years over 13 years of surveillance. […] The annual incidence rate continually trended upwards, with a peak seen in 2015 (5.8 cases per 100,000 person-years). […] A bimodal age-related distribution was observed in female patients, with a first peak seen in adults aged 25-34 years and a second peak in the elderly aged 60-69 years. […] The rising incidence might be related to the significant advancements in neuroimaging, a higher incidentally discovered rate or the increased awareness of pituitary diseases among physicians. […] The SEER database is widely recognized to be among the most reliable resources in reporting epidemiologic features and survival data for various neoplasms. […] The present study found that the annual incidence is increasing and revealed additional factors that associated with overall survival in all histology types with a longer surveillance period. […] More than 80% of the patients survived 10 years and younger age at diagnosis, smaller tumor size, and typical adenoma are associated with prolonged overall survival.

• #29 Prolactinoma epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Prolactinoma_epidemiology_and_demographics

  Prolactinoma commonly affects individuals between 20 and 50 years old. […] Women are more commonly affected by prolactinoma than men. The female to male ratio is approximately 10:1. […] Women aged 20 to 30 years have the highest prevalence of prolactinoma, with a female to male ratio of approximately 14:1. […] Men and women are affected equally after age 50 years. The prevalence of prolactinoma increases with age in men after age 50 and peaks during ages 60 to 70 years. At this time, the female to male ratio is 1:3.

• #30 Prolactinoma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/124634-overview

  Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. This may partially be due to the fact that the male patients often present much later (for clinical evaluation of hypogonadism) than do the female patients (for clinical evaluation of amenorrhea).

• #31 Prolactinoma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/124634-overview

  Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. This may partially be due to the fact that the male patients often present much later (for clinical evaluation of hypogonadism) than do the female patients (for clinical evaluation of amenorrhea).

• #32 Hyperprolactinaemia – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/hyperprolactinaemia.html

  Most prolactinomas are microprolactinomas. They usually do not grow sufficiently to cause hypopituitarism or visual field loss. […] Prolactinomas are tumours arising from the prolactin secreting cells in the pituitary. Most prolactinomas (90%) are microadenomas (1 cm in diameter), which are 10 times more common in women than in men. […] Macroadenomas (1 cm in diameter) are less common and giant prolactinomas (4 cm in diameter) are rare. Compared with women, men are nine times more likely to present with a macroadenoma. […] Patients with a prolactinoma are usually successfully treated with a dopamine agonist such as cabergoline. […] The first-line treatment of a prolactinoma is a dopamine agonist. These are recommended in all patients with a macroprolactinoma and most patients with a symptomatic microprolactinoma.

• #33 Prolactinoma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/124634-overview

  Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. This may partially be due to the fact that the male patients often present much later (for clinical evaluation of hypogonadism) than do the female patients (for clinical evaluation of amenorrhea).

• #34 Prolactinoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22007-prolactinoma

  Prolactinoma is a generally benign (noncancerous) tumor that forms in your pituitary gland and makes more prolactin a hormone than you need. About 50% of pituitary tumor (pituitary adenoma) cases are prolactinomas, making them the most common type of pituitary tumor. […] Among people with prolactinomas, as many as 60% of males have macroprolactinomas, while 90% of females have microprolactinomas. […] Females often notice symptoms earlier due to changes in their periods or milky nipple discharge. But if you’re hormonal medications like birth control pills or hormone replacement therapy you may not experience these symptoms. […] If you have a first-degree relative (biological sibling or parent) who has this condition, you may want to get genetic counseling to check if you have it as well. This may help screen for and catch prolactinoma in its early phases. […] The prognosis (outlook) for someone with prolactinoma is generally good. Medication (dopamine agonists) shrinks small prolactinoma tumors and brings prolactin levels back to normal for 4 out of 5 people receiving this treatment.

• #35 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #36 Prolactinoma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/124634-overview

  Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. This may partially be due to the fact that the male patients often present much later (for clinical evaluation of hypogonadism) than do the female patients (for clinical evaluation of amenorrhea).

• #37 Prolactinoma | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/prolactinoma

  Prolactinomas are the most common type of pituitary adenoma a noncancerous tumor on the pea-size pituitary gland. A prolactinoma causes the body to make too much prolactin, a hormone. […] Men and women at any age can develop a prolactinoma, but women ages 20 to 34 are at highest risk. Prolactinomas are rare in children. […] About one to three people in 10,000 have a prolactinoma that causes symptoms. […] About 5-10% of adults have a prolactinoma that causes no symptoms. Many people dont know they have one, and doctors rarely treat them if discovered. […] Prolactinomas can come back within five years. We will monitor you, especially if you had a large prolactinoma. Our research shows that these tumors can be especially aggressive in men. […] We have also developed ways to predict how likely a tumor is to return, based on a study of more than 800 of our surgical patients. […] We are a national leader in offering clinical trials to test promising new approaches. Your care team will talk with you about any trial that is right for you.

• #38

  https://link.springer.com/article/10.1007/s11102-005-5079-0

  Prolactin-secreting tumors (prolactinomas), the most frequently occurring pituitary tumor, have a frequency that varies with age and sex. They occur most frequently in females aged 20 to 50 years old, at which time the female-to-male ratio is approximately 10:1. […] In the pediatric-adolescent age group, prolactinomas have a prevalence of 100/million population, and account for less than 2% of all intracranial tumors. […] Prolactinomas occur in approximately 30% of patients with multiple endocrine neoplasia type 1 and in this setting, they may be more aggressive than their sporadic counterparts. […] Few familial cases of prolactinoma unrelated to MEN-1 are reported in literature.

• #39 Prolactinoma epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Prolactinoma_epidemiology_and_demographics

  About 45% of pituitary adenomas are prolactinomas, making it the most common type of all pituitary adenomas. Worldwide, the prevalence of sporadic prolactinoma is 6 to 10 per 100,000 persons. The prevalence of prolactinoma in people less than 20 years old is 10 per 100,000 individuals worldwide. Prolactinoma most commonly affects women in reproductive age group (20 to 50 years). Prolactinoma is more common in females than males in people between 20 and 50 years old. Distribution among males and females becomes similar after age 50. […] Worldwide, the prevalence of sporadic prolactinoma ranges from a low of 6 persons per 100,000 persons to a high of 10 persons per 100,000 persons. […] Worldwide, the prevalence of prolactinoma in people less than 20 years old is 10 individuals per 100,000 individuals.

• #40

  https://link.springer.com/article/10.1007/s11102-005-5079-0

  Prolactin-secreting tumors (prolactinomas), the most frequently occurring pituitary tumor, have a frequency that varies with age and sex. They occur most frequently in females aged 20 to 50 years old, at which time the female-to-male ratio is approximately 10:1. […] In the pediatric-adolescent age group, prolactinomas have a prevalence of 100/million population, and account for less than 2% of all intracranial tumors. […] Prolactinomas occur in approximately 30% of patients with multiple endocrine neoplasia type 1 and in this setting, they may be more aggressive than their sporadic counterparts. […] Few familial cases of prolactinoma unrelated to MEN-1 are reported in literature.

• #41 Prolactinoma In childhood and adolescence – a systematic review and meta-analysis | ECE2020 | 22nd European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0070/ea0070aep763

  Data on the epidemiology, effects of dopamine agonists and long term outcome of prolactinoma in children and adolescents have been gradually accumulating but are still scarce. […] A pronounced sex difference was noted with 75.7% (95% CI 69.6 to 81.3%) of patients being female. […] Microprolactinoma occurs almost exclusively in females and is an uncommon diagnosis in males in this age group. Macroprolactinoma is also more common in girls compared to boys. […] A surprising number of patients proceeded to surgery before medical therapy, and surgery is part of overall management in a substantial proportion. Association with other pituitary hormone deficiencies is not uncommon.

• #42 Prolactinoma In childhood and adolescence – a systematic review and meta-analysis | ECE2020 | 22nd European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0070/ea0070aep763

  Data on the epidemiology, effects of dopamine agonists and long term outcome of prolactinoma in children and adolescents have been gradually accumulating but are still scarce. […] A pronounced sex difference was noted with 75.7% (95% CI 69.6 to 81.3%) of patients being female. […] Microprolactinoma occurs almost exclusively in females and is an uncommon diagnosis in males in this age group. Macroprolactinoma is also more common in girls compared to boys. […] A surprising number of patients proceeded to surgery before medical therapy, and surgery is part of overall management in a substantial proportion. Association with other pituitary hormone deficiencies is not uncommon.

• #43 Management of giant prolactinoma causing craniocervical instability: illustrative case in: Journal of Neurosurgery: Case Lessons Volume 1 Issue 23 (2021) Journals

  https://thejns.org/caselessons/view/journals/j-neurosurg-case-lessons/1/23/article-CASE2158.xml

  Giant prolactinomas (4 cm) are a rare entity, constituting less than 1% of all pituitary tumors. Diagnosis can usually be achieved through endocrinological analysis, but biopsy may be considered when trying to differentiate between invasive nonfunctioning pituitary adenomas and primary clival tumors such as chordomas. […] Prolactinomas represent the most common form of functioning pituitary adenomas. These lesions can present as micro- (1 cm) or macroadenomas (1 cm), and patients can present with various symptoms, including galactorrhea, decreased libido, and gynecomastia. Giant prolactinomas (4 cm) are a rare subtype that account for 0.5% to 2% of all pituitary tumors. In even rarer cases, these invasive tumors can cause significant skull base erosion and lead to craniocervical instability.

• #44 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  A total of 1-5% of prolactinomas are giant at presentation (a diameter larger than 4 cm), while most macro-prolactinomas have a diameter between 1 and 4 cm. […] DA resistance is an essential feature of APRLs, but, on the other hand, not all DA-resistant prolactinomas are actually APRLs. […] According to current opinions, DA resistance means the lack of achieving normal prolactin levels and at least 30% reduction in the maximum diameter under high cabergoline doses (at least 3.5 mg/week). […] Subjects with DA resistance become candidates for hypophysectomy and some experts consider that early recognition of patients who are DA non-responsive improves the success of the neurosurgical procedure due to tumor-associated fibrosis which is a direct contributor to incomplete resection. […] Retrospective post-surgery studies have shown that a value of Ki-67 of more than 3% is associated with a higher risk of resistance to medication and post-operatory relapse; however, Ki-67 is not the only useful indicator and this isolated value itself is subject to controversy regarding APRL prognosis.

• #45 Management of giant prolactinoma causing craniocervical instability: illustrative case in: Journal of Neurosurgery: Case Lessons Volume 1 Issue 23 (2021) Journals

  https://thejns.org/caselessons/view/journals/j-neurosurg-case-lessons/1/23/article-CASE2158.xml

  Giant prolactinomas (4 cm) are a rare entity, constituting less than 1% of all pituitary tumors. Diagnosis can usually be achieved through endocrinological analysis, but biopsy may be considered when trying to differentiate between invasive nonfunctioning pituitary adenomas and primary clival tumors such as chordomas. […] Prolactinomas represent the most common form of functioning pituitary adenomas. These lesions can present as micro- (1 cm) or macroadenomas (1 cm), and patients can present with various symptoms, including galactorrhea, decreased libido, and gynecomastia. Giant prolactinomas (4 cm) are a rare subtype that account for 0.5% to 2% of all pituitary tumors. In even rarer cases, these invasive tumors can cause significant skull base erosion and lead to craniocervical instability.

• #46 Orphanet: Prolactinoma

  https://www.orpha.net/en/disease/detail/2965

  In Europe, the prevalence of prolactinoma is reported at between 1/1,600-2,200 (Belgium, UK and Switzerland). A notable female preponderance is observed, particularly among premenopausal women. Prolactinoma accounts for 66% of clinically relevant pituitary adenomas. […] Prolactinomas usually occur sporadically and with the exception of prolactinoma due to MEN1 or FIPA, the occurrence of prolactinomas as part of inherited syndromes is exceptionally rare. In patients with a pathogenic variant of AIP, the inheritance is autosomal dominant and thus offspring of an affected individual have a 50% risk of inheriting the mutation; however, penetrance is variable.

• #47

  https://link.springer.com/article/10.1007/s11102-005-5079-0

  Prolactin-secreting tumors (prolactinomas), the most frequently occurring pituitary tumor, have a frequency that varies with age and sex. They occur most frequently in females aged 20 to 50 years old, at which time the female-to-male ratio is approximately 10:1. […] In the pediatric-adolescent age group, prolactinomas have a prevalence of 100/million population, and account for less than 2% of all intracranial tumors. […] Prolactinomas occur in approximately 30% of patients with multiple endocrine neoplasia type 1 and in this setting, they may be more aggressive than their sporadic counterparts. […] Few familial cases of prolactinoma unrelated to MEN-1 are reported in literature.

• #48 Hyperprolactinaemia and Prolactinoma | Doctor

  https://patient.info/doctor/hyperprolactinaemia-and-prolactinoma

  Hyperprolactinaemia is a relatively common problem and appears to be increasing. The prevalence of hyperprolactinaemia in a UK study was 0.23%. The rising prevalence is thought to be due to a combination of an increase in testing and an increase in drug-related causes. […] Overall incidence of hyperprolactinaemia was 3.5 times higher in women than in men and the highest rates were in women aged 25-44. […] Prolactinomas are the most common hormone-secreting pituitary tumours: 40% of all pituitary tumours are prolactinomas. […] Prevalence is variously reported to be from 6-50 per 100,000 population. […] Prolactinomas occur in about 20% of patients with multiple endocrine neoplasia type 1 (MEN1). […] There is a significant risk of tumour enlargement in pregnancy, particularly with macroadenoma.

• #49 Update in Pathogenesis, Diagnosis, and Therapy of Prolactinoma

  https://www.mdpi.com/2072-6694/14/15/3604

  Prolactinoma accounts for approximately 50% of all pituitary tumors and is the most frequent of all functional PitNETs. The annual incidence of prolactinomas is about 2.2 per 100,000 in Finland. It is most common in women of reproductive age, with an incidence of about 10 per 100,000. Peak incidence occurs around 30 years old but is also seen after menopause. The annual incidence of DA-treated hyperprolactinemia is 24 per 100,000 women aged 25 to 34 in the Netherlands. Male patients are relatively rare, and the disease takes longer to be diagnosed because of the lack of clinical symptoms. […] Prolactinomas are common pituitary neuroendocrine tumors (PitNET) derived from prolactin (PRL)-producing cells that cause hypogonadism and infertility due to hyperprolactinemia. It most frequently occurs in young women and is often associated with galactorrhea and amenorrhea. Most cases are sporadic, but prolactinomas may also occur because of mutations of the multiple endocrine neoplasia type 1 (MEN1) or aryl hydrocarbon receptor-interacting protein (AIP) gene. Medical therapy with a dopamine agonist (DA) is highly effective in the majority of cases.

• #50 Treatment of Prolactinoma

  https://www.mdpi.com/1648-9144/58/8/1095

  Prolactinomas are the commonest pituitary neuroendocrine tumor (PitNET), with a recent epidemiological review estimating that this tumor subtype makes up 53% of PitNETs. […] The pathway to diagnosis of prolactinoma may be via hormonal investigation of symptoms of reproductive dysfunction such as menstrual disturbance and galactorrhea in females or erectile dysfunction, loss of libido, and rarely galactorrhea in males. […] Natural history studies of patients with microprolactinomas have demonstrated that they rarely increase in size, even if left untreated. […] Prolactinomas are less common in men overall, but the proportion of macroadenomas, particularly large, invasive tumors is higher. […] Prolactinomas may present as part of a genetic syndrome such as multiple endocrine neoplasia type 1 (MEN1) or type 4 (MEN4), Succinate dehydrogenase (SDHx) mutations, and aryl hydrocarbon receptor interacting protein (AIP)-associated familial pituitary adenoma syndrome (FIPA).

• #51 The Epidemiology of Prolactinomas – ProQuest

  https://www.proquest.com/scholarly-journals/epidemiology-prolactinomas/docview/222807278/se-2

  Prolactin-secreting tumors (prolactinomas), the most frequently occurring pituitary tumor, have a frequency that varies with age and sex. They occur most frequently in females aged 20 to 50 years old, at which time the female-to-male ratio is approximately 10:1. In the pediatric-adolescent age group, prolactinomas have a prevalence of 100/million population, and account for less than 2% of all intracranial tumors. Prolactinomas occur in approximately 30% of patients with multiple endocrine neoplasia type 1 and in this setting, they may be more aggressive than their sporadic counterparts. […] Patients with Carney complex or McCune-Albright syndrome may exhibit hyperprolactinemia due to a pituitary tumor derived from somatomammotropic cells that secrete both growth hormone and prolactin. Few familial cases of prolactinoma unrelated to MEN-1 are reported in literature.

• #52

  https://link.springer.com/article/10.1007/s11102-005-5079-0

  Prolactin-secreting tumors (prolactinomas), the most frequently occurring pituitary tumor, have a frequency that varies with age and sex. They occur most frequently in females aged 20 to 50 years old, at which time the female-to-male ratio is approximately 10:1. […] In the pediatric-adolescent age group, prolactinomas have a prevalence of 100/million population, and account for less than 2% of all intracranial tumors. […] Prolactinomas occur in approximately 30% of patients with multiple endocrine neoplasia type 1 and in this setting, they may be more aggressive than their sporadic counterparts. […] Few familial cases of prolactinoma unrelated to MEN-1 are reported in literature.

• #53 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Pituitary adenomas (PAs) are defined as benign monoclonal tumors in the pituitary gland that cause symptoms due to either hormonal hypersecretion or a space-occupying effect, and are classified as functioning or non-functioning. […] Considering their public health impact and association with increased morbidity and mortality, however, it is essential to understand the prevalence and incidence of PAs in order to improve patient outcomes and to minimize the resultant burden on the health care system. […] PAs were previously considered to be very rare, but recent data have revealed that their prevalence is higher than previously reported, potentially due to developments in imaging techniques and the increased detection of incidentalomas found during radiological work-ups for other diseases.

• #54 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Epidemiologic data on PAs based on a national-level cancer registry have been reported, but it has also limitation of underestimating the actual prevalence of PAs due to the lack of mandatory reporting. […] Recently, population studies on the basis of big data analysis using national insurance claims data in Korea have been published. […] Despite the issue on the accuracy of their operational definitions, used in these studies, they have the advantage of enabling investigators to obtain epidemiologic data from the general population, and this method has therefore been applied in various studies for other diseases. […] This review summarizes the previously reported epidemiologic data on functioning PAs in Korea and other countries. […] With mostly benign, prolactin-producing PAs (prolactinomas) are known to be one of the most common causes of hyperprolactinemia.

• #55 Prolactinoma – Wikipedia

  https://en.wikipedia.org/wiki/Prolactinoma

  Autopsy studies indicate that 6-25% of the U. S. population have small pituitary tumors. Forty percent of these pituitary tumors produce prolactin, but most are not considered clinically significant. Clinically significant pituitary tumors affect the health of approximately 14 out of 100,000 people. In non-selective surgical series, this tumor accounts for approximately 25-30% of all pituitary adenomas. Some growth hormone (GH) producing tumors also co-secrete prolactin. More than 90% of prolactinoma is microprolactinomas, which are much more common than macroprolactinomas.

• #56 Pituitary Adenoma – EyeWiki

  https://eyewiki.org/Pituitary_Adenoma

  Pituitary adenomas are reported to account for 12-15% of symptomatic intracranial neoplasms and are the most common tumor of the sella turcica region. […] Overall, it is estimated that in upwards of 25% of the population have pituitary adenomas although most of these are incidentally found. […] One review found an average incidence of 16.7% (14.4% in autopsy studies and 22.5% in radiologic studies). […] Pituitary adenomas usually occur in adults; they rarely occur in childhood. […] Various articles have reported both male and female predilections. […] While most pituitary adenomas occur in isolation, 3% of cases are associated with multiple endocrine neoplasia (MEN) type 1. […] Medical treatment is considered the primary treatment for prolactinomas. […] Dopamine agonists (e.g., bromocriptine or cabergoline) have been shown to normalize hyperprolactinemia as well as shrink tumors.

• #57 Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016 | Scientific Reports

  https://www.nature.com/articles/s41598-021-94658-8

  The overall standardized incidence rate was 4.8 cases per 100,000 person-years over 13 years of surveillance. […] The annual incidence rate continually trended upwards, with a peak seen in 2015 (5.8 cases per 100,000 person-years). […] A bimodal age-related distribution was observed in female patients, with a first peak seen in adults aged 25-34 years and a second peak in the elderly aged 60-69 years. […] The rising incidence might be related to the significant advancements in neuroimaging, a higher incidentally discovered rate or the increased awareness of pituitary diseases among physicians. […] The SEER database is widely recognized to be among the most reliable resources in reporting epidemiologic features and survival data for various neoplasms. […] The present study found that the annual incidence is increasing and revealed additional factors that associated with overall survival in all histology types with a longer surveillance period. […] More than 80% of the patients survived 10 years and younger age at diagnosis, smaller tumor size, and typical adenoma are associated with prolonged overall survival.

• #58 Prolactinoma | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/prolactinoma

  Prolactinomas are the most common type of pituitary adenoma a noncancerous tumor on the pea-size pituitary gland. A prolactinoma causes the body to make too much prolactin, a hormone. […] Men and women at any age can develop a prolactinoma, but women ages 20 to 34 are at highest risk. Prolactinomas are rare in children. […] About one to three people in 10,000 have a prolactinoma that causes symptoms. […] About 5-10% of adults have a prolactinoma that causes no symptoms. Many people dont know they have one, and doctors rarely treat them if discovered. […] Prolactinomas can come back within five years. We will monitor you, especially if you had a large prolactinoma. Our research shows that these tumors can be especially aggressive in men. […] We have also developed ways to predict how likely a tumor is to return, based on a study of more than 800 of our surgical patients. […] We are a national leader in offering clinical trials to test promising new approaches. Your care team will talk with you about any trial that is right for you.

• #59 The Vanishing Pituitary Tumor: A Case Report | Lee | Journal of Endocrinology and Metabolism

  https://jofem.org/index.php/jofem/article/view/753/284284536

  Prolactinomas are the most common functional pituitary tumors and present with elevated serum prolactin levels. […] Prolactinomas are the most common functional adenomas and occur most frequently among women aged 20 – 50 years. […] Data on prolactinoma remission and relapse after treatment withdrawal remain limited. […] Prolactinoma recurrence is most commonly seen during the first 6 to 12 months following cessation of treatment, and recurrence rates can be as high as 93% for macroprolactinomas and 64% for microprolactinomas. […] Patients with microadenomas and those with macroadenomas and a negative MRI scan after treatment are good candidates for drug withdrawal. […] Among patients successfully treated with dopamine agonists, follow-up after 24 months of treatment withdrawal showed that approximately 60-70% remained in remission.

• #60 The Vanishing Pituitary Tumor: A Case Report | Lee | Journal of Endocrinology and Metabolism

  https://jofem.org/index.php/jofem/article/view/753/284284536

  Prolactinomas are the most common functional pituitary tumors and present with elevated serum prolactin levels. […] Prolactinomas are the most common functional adenomas and occur most frequently among women aged 20 – 50 years. […] Data on prolactinoma remission and relapse after treatment withdrawal remain limited. […] Prolactinoma recurrence is most commonly seen during the first 6 to 12 months following cessation of treatment, and recurrence rates can be as high as 93% for macroprolactinomas and 64% for microprolactinomas. […] Patients with microadenomas and those with macroadenomas and a negative MRI scan after treatment are good candidates for drug withdrawal. […] Among patients successfully treated with dopamine agonists, follow-up after 24 months of treatment withdrawal showed that approximately 60-70% remained in remission.

• #61 The Vanishing Pituitary Tumor: A Case Report | Lee | Journal of Endocrinology and Metabolism

  https://jofem.org/index.php/jofem/article/view/753/284284536

  As of this writing, there are no definite guidelines with regards to the duration of surveillance of prolactin levels among patients in remission. […] Prospective studies are needed to define the optimal surveillance duration after treatment withdrawal in both macro- and microprolactinomas as recurrence rates are different for both.

• #62 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #63 Cabergoline-associated valvulopathy of the tricuspid valve in the treatment of prolactinoma in: Endocrine Oncology Volume 3 Issue 1 (2023)

  https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0086.xml

  Cabergoline-associated valvulopathy (CAV) is defined by the echocardiographic triad of moderate or severe regurgitation, valvular thickening and restricted valvular motion. […] The novel finding of CAV affecting the tricuspid valve suggests a possible link between confirmed cases of CAV and the echocardiographic surveillance studies of cabergoline-treated prolactinoma patients which have mostly demonstrated subclinical tricuspid valve changes. […] The risk of CAV, although small, prompts a mindful prescription of dopamine agonist therapy for prolactinomas and consideration of measures to minimise cabergoline exposure. […] The cumulative cabergoline doses and duration of therapy associated with CAV in published cases exceed what has been evaluated in case series and surveillance studies, underscoring the importance of case reports in understanding CAV.

• #64 Cabergoline-associated valvulopathy of the tricuspid valve in the treatment of prolactinoma in: Endocrine Oncology Volume 3 Issue 1 (2023)

  https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0086.xml

  Cabergoline-associated valvulopathy (CAV) is defined by the echocardiographic triad of moderate or severe regurgitation, valvular thickening and restricted valvular motion. […] The novel finding of CAV affecting the tricuspid valve suggests a possible link between confirmed cases of CAV and the echocardiographic surveillance studies of cabergoline-treated prolactinoma patients which have mostly demonstrated subclinical tricuspid valve changes. […] The risk of CAV, although small, prompts a mindful prescription of dopamine agonist therapy for prolactinomas and consideration of measures to minimise cabergoline exposure. […] The cumulative cabergoline doses and duration of therapy associated with CAV in published cases exceed what has been evaluated in case series and surveillance studies, underscoring the importance of case reports in understanding CAV.

• #65 Epidemiology and Management Challenges in Prolactinomas – Turku University

  http://utuvolter.fi/discovery/fulldisplay?docid=cdi_pubmed_primary_30731464&context=PC&vid=358FIN_UTUR:VU1&lang=fi&search_scope=MyInst_and_CI&adaptor=Primo%20Central&tab=Everything&query=sub%2Cexact%2C%20dopamine%20agonist%20&offset=20

  Clinically relevant pituitary adenomas are present in about 1 per 1,000 of the general population and prolactinomas are by far the most common clinical subtype of pituitary adenomas. Usually prolactinomas affect premenopausal women and present with typical symptoms of menstrual disturbance and/or galactorrhea. They are generally managed with dopamine agonists to restore fertility and to control symptoms and tumor size. In a subset of prolactinomas, however, management remains challenging. Studies in recent years have identified the factors related to dopamine agonist resistance, such as male sex, genetic features, and aggressive tumor behavior. Certain other patient groups represent particular challenges for management, such as pediatric patients and pregnant women. Treatment with dopamine agonists is usually safe and effective, and adverse effects such as clinically relevant cardiac valvular complications and impulse control disorders may occur in isolated instances. A number of important disease characteristics of prolactinomas remain to be explained, such as the difference in sex prevalence before and after menopause, the higher prevalence of macroadenomas in older males, and the biochemical mechanisms of resistance to dopaminergic agonists.

• #66 Cabergoline-associated valvulopathy of the tricuspid valve in the treatment of prolactinoma in: Endocrine Oncology Volume 3 Issue 1 (2023)

  https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0086.xml

  The accepted population at greatest risk is those aged over 50 or in whom total cumulative dose exceeds 520720 mg (approximately 23 mg weekly for 5 years). […] A reasonable approach would therefore include echocardiography at baseline and at 5 years, increasing thereafter. […] Clinically suspected CAV should be formally diagnosed using echocardiography to document the triad of moderate or severe regurgitation, valvular thickening and restricted motion. […] More broadly, the risk of CAV, although small, prompts a mindful prescription of DA therapy for prolactinoma. […] Consideration of DA withdrawal is important where appropriate to minimise overall cabergoline exposure and thus CAV risk.

• #67 Cabergoline-associated valvulopathy of the tricuspid valve in the treatment of prolactinoma in: Endocrine Oncology Volume 3 Issue 1 (2023)

  https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0086.xml

  Cabergoline-associated valvulopathy is a rare but serious complication in the treatment of prolactinoma. […] Potential surveillance strategies include baseline echocardiography, followed by periodic clinical examination, and serial echocardiography every 15 years depending on risk and dopamine agonist exposure. […] To date, there has been a disconnect in the prolactinoma literature between the multiple echocardiographic surveillance studies performed in cabergoline-treated patients and the few case reports of clinically apparent CAV. […] Meta-analysis of surveillance studies has shown an increased risk of asymptomatic moderate tricuspid regurgitation in cabergoline-treated prolactinoma patients up to a mean follow-up of 7 years, without evidence of any other valvulopathy. […] Endocrinologists should be cognisant of the risk of CAV.

• #68 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Pituitary adenomas (PAs) are defined as benign monoclonal tumors in the pituitary gland that cause symptoms due to either hormonal hypersecretion or a space-occupying effect, and are classified as functioning or non-functioning. […] Considering their public health impact and association with increased morbidity and mortality, however, it is essential to understand the prevalence and incidence of PAs in order to improve patient outcomes and to minimize the resultant burden on the health care system. […] PAs were previously considered to be very rare, but recent data have revealed that their prevalence is higher than previously reported, potentially due to developments in imaging techniques and the increased detection of incidentalomas found during radiological work-ups for other diseases.

• #69 Pituitary disease: An update

  https://www1.racgp.org.au/ajgp/2021/january-february/pituitary-disease-an-update

  The prevalence of symptomatic pituitary tumours in the population is approximately one in 1000 people. Pituitary adenomas may be functional or non-functioning. Prolactinomas are the most common pituitary tumours, comprising over 50% in some series, while clinically non-functioning pituitary adenomas make up approximately 30% of cases. […] Hyperprolactinaemia is discovered in approximately 15% of cases of secondary amenorrhea in women of reproductive age, and the measurement of serum prolactin should be undertaken in all women presenting with menstrual disturbance or infertility.

• #70 Prolactinoma: Early Detection, Evaluation and Management – The ObG Project

  https://www.obgproject.com/2017/04/18/prolactinoma-early-detection-evaluation-and-management/

  Prolactinomas are generally benign prolactin-secreting tumors and account for 40-66% of all pituitary adenomas. The vast majority are microadenomas (diameter < 1cm) and suppress the hypothalamic-pituitary gonadal hormonal axis, while 10% are macroadenomas (≥ 1cm) and may cause additional mass effects due to size. Age prevalence varies widely, but they are commonly found in women during childbearing years, in part due to development of menstrual irregularities. Despite their benign nature, if diagnosis is delayed bone loss and vertebral fractures can occur, and the loss of bone density can be permanent. [...] The prevalence of prolactinomas is reported to be between 35 to 50 per 100,000. They are most commonly seen in women (10:1 ratio female/male) and the usual age range is between 20 to 50 years of age.

• #71 Pituitary disease: An update

  https://www1.racgp.org.au/ajgp/2021/january-february/pituitary-disease-an-update

  The prevalence of symptomatic pituitary tumours in the population is approximately one in 1000 people. Pituitary adenomas may be functional or non-functioning. Prolactinomas are the most common pituitary tumours, comprising over 50% in some series, while clinically non-functioning pituitary adenomas make up approximately 30% of cases. […] Hyperprolactinaemia is discovered in approximately 15% of cases of secondary amenorrhea in women of reproductive age, and the measurement of serum prolactin should be undertaken in all women presenting with menstrual disturbance or infertility.

• #72 Review of Clinical Recommendations on Prolactinoma and Pregnancy

  https://www.endocrinolrespract.org/en/review-of-clinical-recommendations-on-prolactinoma-and-pregnancy-13333

  Prolactinomas are the most common hormone-secreting pituitary adenomas. Prolactinomas account for nearly 3040 percent of all the pituitary adenomas. Although it affects individuals over a wide age range, it is more common in 2040-year-old female patients, who are in their reproductive age. Prolactinomas may cause hypogonadism, menstrual cycle dysfunction (oligomenorrhea or amenorrhea) and infertility (luteal phase abnormalities or anovulation) in premenopausal women. […] When pregnancy is excluded, hyperprolactinemia in approximately 10 to 20 percent of the patients results in amenorrhea. Women with untreated prolactinomas are generally unable to achieve pregnancy, as the hyperprolactinemia affects the pulsatility of gonadotropin-releasing hormone (GnRH) and diminishes follicle-stimulating hormone (FSH) as well as luteinizing hormone (LH) secretion. The sum of these effects induces amenorrhea, infertility, and hypogonadism, thereby posing difficulties in fertility. Therefore, in most women prolactinoma is diagnosed prior to conception. However, ovulation and fertility usually improve after proper diagnosis and treatment of prolactinoma. Therefore, during the surveillance of these patients, the onset of pregnancy is a common phenomenon. Management of these pregnancies may sometimes be challenging and require a multidisciplinary approach involving an endocrinologist, a gynecologist, a radiologist and an experienced neurosurgeon in order to achieve the best outcomes both for the patient as well the infant.

• #73 Pituitary Tumours | UKOSS | NPEU

  https://www.npeu.ox.ac.uk/ukoss/completed-surveillance/pt

  Pituitary Tumours are rare and complicate approximately 1 in 4500 pregnancies in the UK. […] Macroprolactinoma is a benign tumour of the pituitary that is 1cm or more in diameter and produces a hormone called prolactin. […] Pituitary tumours that secrete excess hormones are associated with a higher incidence of mortality and morbidity. […] Following this study we will be able to provide comprehensive information on maternal/fetal outcome related to medications used to treat pituitary tumours and this will be used as the basis for the development of clinical management guidelines. […] To use the UK Obstetric Surveillance System to describe the maternal and fetal outcomes in women with pituitary tumours in pregnancy. […] What are the current monitoring and management strategies for women with pituitary tumours during pregnancy? […] All women in the UK with a pituitary tumour in pregnancy excluding a microprolactinoma (a prolactin-secreting tumour less than 1.0cm diameter).

• #74 Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016 | Scientific Reports

  https://www.nature.com/articles/s41598-021-94658-8

  The overall standardized incidence rate was 4.8 cases per 100,000 person-years over 13 years of surveillance. […] The annual incidence rate continually trended upwards, with a peak seen in 2015 (5.8 cases per 100,000 person-years). […] A bimodal age-related distribution was observed in female patients, with a first peak seen in adults aged 25-34 years and a second peak in the elderly aged 60-69 years. […] The rising incidence might be related to the significant advancements in neuroimaging, a higher incidentally discovered rate or the increased awareness of pituitary diseases among physicians. […] The SEER database is widely recognized to be among the most reliable resources in reporting epidemiologic features and survival data for various neoplasms. […] The present study found that the annual incidence is increasing and revealed additional factors that associated with overall survival in all histology types with a longer surveillance period. […] More than 80% of the patients survived 10 years and younger age at diagnosis, smaller tumor size, and typical adenoma are associated with prolonged overall survival.

• #75 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #76 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #77 Prolactinoma | UVA Health

  https://uvahealth.com/services/benign-brain-tumor/prolactinoma

  Prolactinomas are the most common type of hormone-secreting pituitary adenoma. Women are 5 times more likely than men to have them. Most prolactinomas appear in people under age 40 but are rare in children. […] Early diagnosis allows for tumors to be diagnosed when they are small, which improves the chance of cure following surgery alone. […] Doctors can find a prolactinoma using either of these tests: Serum prolactin value (Elevated prolactin of greater than 150 ng/ml generally indicates the presence of a tumor) and MRI scan.

• #78 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #79

  https://apcz.umk.pl/QS/article/view/53224

  Prolactinoma is a benign tumor of the pituitary gland that leads to the overproduction of prolactin. It is the most common type of pituitary adenoma, accounting for approximately 50% of all pituitary tumors. […] The epidemiology of hyperprolactinaemia over 20 years in the Tayside region of Scotland: the prolactin epidemiology, audit and research study (PROLEARS). Clinical Endocrinology 2017; 86:60e7. […] The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new. Best Pract Res Clin Endocrinol Metab. 2019 Apr;33(2):101290. […] The epidemiology of pituitary adenomas in Iceland, 1955-2012: a nationwide population-based study. Eur J Endocrinol 2015; 173:655e64. […] High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 2006;91:4769e75. […] Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf) 2010;72:377e82. […] The incidence rate of pituitary adenomas in western Sweden for the period 2001-2011. Eur J Endocrinol 2014;171:519e26.

• #80 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #81 The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31326373/

  Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. […] DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. […] Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. […] Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.

• #82 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  Prolactinoma affects both females and males, having an incidence of 3-5 cases/100,000 individuals/year and a general prevalence of 50 cases/100,000 individuals which is higher in subjects with hypogonadism since increased prolactin levels induce central inhibition of gonadotropes through kisspeptin neurons. […] The detection of APRLs may not start from the clinical presentation itself, but the imaging detection of a large pituitary mass in addition to large mass-associated symptoms and signs and extremely elevated prolactin levels are important clues, further followed by a poor response to DA medication and need for neurosurgery/early relapse after hypophysectomy due to the unusual rapid growth. […] Generally, a patient with prolactinoma becomes a neurosurgery candidate in the event apoplexy or cystic transformation is present, neurological/ophthalmic deficit has been identified, and the patient develops DA resistance or intolerance.

• #83 Orphanet: Prolactinoma

  https://www.orpha.net/en/disease/detail/2965

  In Europe, the prevalence of prolactinoma is reported at between 1/1,600-2,200 (Belgium, UK and Switzerland). A notable female preponderance is observed, particularly among premenopausal women. Prolactinoma accounts for 66% of clinically relevant pituitary adenomas. […] Prolactinomas usually occur sporadically and with the exception of prolactinoma due to MEN1 or FIPA, the occurrence of prolactinomas as part of inherited syndromes is exceptionally rare. In patients with a pathogenic variant of AIP, the inheritance is autosomal dominant and thus offspring of an affected individual have a 50% risk of inheriting the mutation; however, penetrance is variable.

• #84 Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2021.1000

  Only a few studies have established the epidemiology of prolactinoma and Cushings disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushings disease and their survival analysis according to treatment. […] The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushings disease. […] Overall, the incidence of prolactinoma and Cushings disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. […] The incidence of prolactinomas was 23.5 cases per million, and its prevalence was 82.5 cases per million. The incidence of CD was 2.3 cases per million, and its prevalence was 9.8 cases per million.

• #85 Update in Pathogenesis, Diagnosis, and Therapy of Prolactinoma

  https://www.mdpi.com/2072-6694/14/15/3604

  Prolactinoma accounts for approximately 50% of all pituitary tumors and is the most frequent of all functional PitNETs. The annual incidence of prolactinomas is about 2.2 per 100,000 in Finland. It is most common in women of reproductive age, with an incidence of about 10 per 100,000. Peak incidence occurs around 30 years old but is also seen after menopause. The annual incidence of DA-treated hyperprolactinemia is 24 per 100,000 women aged 25 to 34 in the Netherlands. Male patients are relatively rare, and the disease takes longer to be diagnosed because of the lack of clinical symptoms. […] Prolactinomas are common pituitary neuroendocrine tumors (PitNET) derived from prolactin (PRL)-producing cells that cause hypogonadism and infertility due to hyperprolactinemia. It most frequently occurs in young women and is often associated with galactorrhea and amenorrhea. Most cases are sporadic, but prolactinomas may also occur because of mutations of the multiple endocrine neoplasia type 1 (MEN1) or aryl hydrocarbon receptor-interacting protein (AIP) gene. Medical therapy with a dopamine agonist (DA) is highly effective in the majority of cases.

• #86 SciELO Brazil – Incidence and prevalence of clinically relevant pituitary adenomas: retrospective cohort study in a Health Management Organization in Buenos Aires, Argentina Incidence and prevalence of clinically relevant pituitary adenomas: retrospectiv

  https://www.scielo.br/j/aem/a/W7bw5Zhtg7hxK5gmLCSNbXt/?lang=en

  Prolactinomas had also the highest prevalence rate: 56.29 (44.98-70.44)/100,000; 83% were harbored by women, and 70% were microadenomas. […] The overall SIR, as clearly depicted in Figure 2, mainly arises as a result of the high incidence of prolactinomas [5.41 (2.57-8.25)], which accounted for 57% of all of our PAs. […] Prolactinomas also affected younger females, and most were microadenomas, showing the gender differences described by several authors.

• #87 Prolactinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459347/

  Prolactinomas account for up to 40% of all clinically recognized pituitary adenomas. The mean prevalence of prolactinoma is estimated to be approximately 10 per 100,000 in men and 30 per 100,000 in women, with a peak prevalence in women aged 25 to 34 years. Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. […] Prolactin-secreting tumors of the pituitary gland, also known as prolactinomas, are the most common secretory tumors of the pituitary gland, accounting for up to 40 percent of pituitary adenomas.

• #88 Prolactinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459347/

  Prolactinomas account for up to 40% of all clinically recognized pituitary adenomas. The mean prevalence of prolactinoma is estimated to be approximately 10 per 100,000 in men and 30 per 100,000 in women, with a peak prevalence in women aged 25 to 34 years. Among patients with prolactinomas, as many as 60% of the males present with macroprolactinomas, while 90% of the females present with microprolactinomas. […] Prolactin-secreting tumors of the pituitary gland, also known as prolactinomas, are the most common secretory tumors of the pituitary gland, accounting for up to 40 percent of pituitary adenomas.

• #89 Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-023-00886-5

  Microprolactinomas rarely proliferate and are of low concern for persistent long-term adenoma growth (strong). […] Macroprolactinomas, especially in men, have a different clinical prognosis compared with microadenomas and require closer follow-up (strong). […] Prolactinomas, which are most commonly benign prolactin-secreting adenomas derived from lactotrophs, account for 50% of all pituitary adenomas in both women and men. At age 25-44 years, prolactinomas predominantly affect women, with a female to male ratio of 5:1 to 10:1, whereas after menopause the ratio equalizes. The standardized incidence rate in women is three times higher than in men. The ratio between macroprolactinomas and microprolactinomas is approximately 1:8 in women and 4:1 in men. […] Over the past two decades, studies indicate a higher prevalence of prolactinomas than previously predicted.

• #90 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #91 The Vanishing Pituitary Tumor: A Case Report | Lee | Journal of Endocrinology and Metabolism

  https://jofem.org/index.php/jofem/article/view/753/284284536

  As of this writing, there are no definite guidelines with regards to the duration of surveillance of prolactin levels among patients in remission. […] Prospective studies are needed to define the optimal surveillance duration after treatment withdrawal in both macro- and microprolactinomas as recurrence rates are different for both.

• #92 Epidemiology of Functioning Pituitary Adenomas

  https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2020.35.2.237

  Ezzat et al. performed a meta-analysis demonstrating that prolactinomas were the most common PAs, accounting for 25% to 41% according to radiologic or autopsy studies. […] According to the analysis by Park et al. of the HIRA claims database between 2009 and 2013, the prevalence of prolactinomas in Korea increased from 38.5 to 68.6 cases per million, while the annual incidence showed a sex disparity, at 1.0 to 1.6 cases per million in males and 27 to 29 cases per million in females. […] Because of their rarity and slow-growing, symptomless nature in most cases, it is very difficult to collect clinically reliable information on patients with PAs, which presents a solid barrier to investigations of the epidemiology of this disorder. […] As population studies based on big-data analyses have become more common and provided easier access to more dependable data; however, the prevalence and incidence of PAs have been found to increase over the past years. […] As mentioned repeatedly, not many studies have investigated the epidemiology of PAs in Korea, and updated and larger studies regarding the epidemiology of PAs are necessary.

• #93 Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016 | Scientific Reports

  https://www.nature.com/articles/s41598-021-94658-8

  The overall standardized incidence rate was 4.8 cases per 100,000 person-years over 13 years of surveillance. […] The annual incidence rate continually trended upwards, with a peak seen in 2015 (5.8 cases per 100,000 person-years). […] A bimodal age-related distribution was observed in female patients, with a first peak seen in adults aged 25-34 years and a second peak in the elderly aged 60-69 years. […] The rising incidence might be related to the significant advancements in neuroimaging, a higher incidentally discovered rate or the increased awareness of pituitary diseases among physicians. […] The SEER database is widely recognized to be among the most reliable resources in reporting epidemiologic features and survival data for various neoplasms. […] The present study found that the annual incidence is increasing and revealed additional factors that associated with overall survival in all histology types with a longer surveillance period. […] More than 80% of the patients survived 10 years and younger age at diagnosis, smaller tumor size, and typical adenoma are associated with prolonged overall survival.

• #94 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  A total of 1-5% of prolactinomas are giant at presentation (a diameter larger than 4 cm), while most macro-prolactinomas have a diameter between 1 and 4 cm. […] DA resistance is an essential feature of APRLs, but, on the other hand, not all DA-resistant prolactinomas are actually APRLs. […] According to current opinions, DA resistance means the lack of achieving normal prolactin levels and at least 30% reduction in the maximum diameter under high cabergoline doses (at least 3.5 mg/week). […] Subjects with DA resistance become candidates for hypophysectomy and some experts consider that early recognition of patients who are DA non-responsive improves the success of the neurosurgical procedure due to tumor-associated fibrosis which is a direct contributor to incomplete resection. […] Retrospective post-surgery studies have shown that a value of Ki-67 of more than 3% is associated with a higher risk of resistance to medication and post-operatory relapse; however, Ki-67 is not the only useful indicator and this isolated value itself is subject to controversy regarding APRL prognosis.

• #95 An 18-year Odyssey: navigating the complex path of prolactinoma management: a case report | Cardiovascular Diabetology – Endocrinology Reports | Full Text

  https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-025-00218-8

  However, despite these therapeutic advances, a subset of prolactinomas prove recalcitrant to conventional treatments, necessitating consideration of surgical and radiotherapeutic interventions. […] Aggressive prolactinomas represent a subset of prolactin-secreting tumors distinguished by their aggressive growth pattern and resistance to conventional therapies. While comprising only 15% of prolactinomas, these tumors pose significant diagnostic and therapeutic challenges due to their radiologically invasive nature, rapid growth rate, and high recurrence potential. […] The introduction of immunotherapy represents a novel approach to addressing resistant tumors, though its efficacy in prolactinomas remains uncertain. Further research is warranted to elucidate the role of immunotherapy and other emerging treatments in refractory pituitary adenomas.

• #96 The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31326373/

  Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. […] DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. […] Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. […] Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.

• #97 Aggressive prolactinoma (Review)

  https://www.spandidos-publications.com/10.3892/etm.2021.10997

  Radiotherapy for pituitary tumors is useful if other medical and surgical procedures do not control the condition; the risk of hypopituitarism is high and in certain circumstances the risk of a secondary brain tumor should be taken into account. […] Temozolomide, an active chemotherapy drug, represents a fourth-line therapy in prolactinomas after DA, transphenoidal selective hypophysectomy and radiotherapy. […] APRLs represent a challenging condition that requires a multimodal approach; in addition to a standard three-line therapy, temozolomide medication is required.

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