ECE2022 Eposter Presentations Pituitary and Neuroendocrinology (211 abstracts)
Giant prolactinomas: a descriptive study and prognostic analysis
Mouna Elleuch , Hamdi Frikha , Loukil Fatma , Dhoha Ben Salah , Maalej Souhir , Mouna Mnif , Fatma Mnif , Nadia Charfi , Nabila Rekik Majdoub , Faten Haj Kacem Akid & Mohamed Abid
Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia
Introduction: Giant prolactinomas (GP), defined as prolactinomas ≥4 cm in maximum dimension, are uncommon, with reported prevalence of 2 to 3% of all prolactinomas.
Aim: The aim of this study is to describe clinical and paraclinical characteristics of GP and to identify predictors of therapeutic response.
Matherials and methods: A retrospective, single-center, descriptive study including 18 patients with GP followed at the endocrinology department of Hedi Chaker University Hospital of Sfax, Tunisia.
Results: Mean age was 42.9 ±16.9 years. Patients were predominantly male (77.8%). Mean tumor size was 50.4 ±9.3 mm with a maximum of 70 mm. Prolactinemia at diagnosis was 10569.1 ±19667 ng/ml on average [56-81940]. Clinically, main symptoms included signs of intracranial hypertension (78%) and visual field defects (72.2%). Galactorrhea was reported in 25% of patients only. Pituitary insufficiency included thyrotropic, corticotroph and gonadotropic axes in 33%, 11% and 50% of cases respectively. Sixteen patients were treated with dopamin agonists (bromocriptin 75% and cabergolin 25%), 3 of them showed resistance to medical treatment. Surgery was indicated in 7 cases during follow-up: optic chiasm compression (4 cases) and resistance to medical treatment (3 cases). Mean prolactinemia at 1 year of follow-up was 726.3 ±1315.2 ng/ml. A strong correlation was found between initial prolactinemia and six-month decrease of prolactin level (r=0.68; P=0.04). However, therapeutic response did not correlate with age or initial tumor size. There was no reported case of complete remission.
Conclusion: GP is a rare form of prolactinomas. It mainly affects men and its symptoms are due to mass-effect. GP respond generally well to dopamin agonists. Initial prolactinemia could be a good marker of therapeutic response.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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