Introduction: Prolactinomas are the most common pituitary adenomas. Several authors hypothesized that there is an association between the development of pituitary adenomas and psychologically significant experiences, especially traumatic ones. This is particularly well-established for Cushings disease. When it comes to prolactinomas, it was suggested that prolactin acts as an alternative to cortisol in the response to stress, especially in patients who present with passive coping strategies. We looked at the influence of traumatic experiences before the age of ten on the susceptibility to the subsequent development of prolactinomas.
Methods: We compared a group of 33 patients with the diagnosis of prolactinoma to the same number of patients of the same age and gender with non-functioning pituitary adenomas and Cushings disease. We studied the difference between the patients with prolactinomas and the two other subtypes of adenomas in relation to the absence of a father before the age of ten, and to the presence of an alcoholic or violent father during the same period.
Results: We observed a higher frequency of traumatic childhood experiences, especially the presence of an alcoholic father, in patients with prolactinomas (33,3%) when compared to the other adenomas (9,8%, P<0.05). Contrary to what we expected, patients with Cushings disease reported not living with their father during childhood the most. This result is similar to that found in previous studies, where there was also an association between traumatic events and the development of these neoplasms.
Conclusion: Traumatic experiences during childhood seem to increase the susceptibility to the development of prolactinomas, especially in patients who lived with an alcoholic father. On the contrary, the absence of a father seems to favor the development of Cushings disease. Experiencing traumatic situations during childhood may interfere with epigenetic processes which silence tumor suppressor genes and promote the development of pituitary adenomas.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.