ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)
Prolactin-secreting pituitary adenoma: Clinical, radiological features and predictors of response to dopamine agonists
Martina Romanisio 1 , Alice Ferrero 1 , Tommaso Daffara 1 , Sara Catenazzi 1 , Rosa Pitino 1 , Beatrice Cavigiolo 1 , Marco Zavattaro 1 , Paolo Marzullo 1 , Marina Caputo 1,2 , Flavia Prodam 1,2 & Gianluca Aimaretti 1
1Endocrinology, Department of Translational Medicine, Novara, Italy; 2Department of Health Sciences, Novara, Italy
Aim: Prolactinomas are the most frequent pituitary adenomas. Clear predictors of response to dopamine agonists (DA) are still discussed. The purpose of the study was to evaluate the clinical, radiological and hormonal characteristics of PRL-secreting pituitary adenomas, and to evaluate morphological changes over time and predictors of response to DA.
Patients and Methods: Patients affected by PRL-secreting adenoma undergoing DA therapy in follow-up in a tertiary care center (2000–2021) were retrospectively evaluated. Demographic (sex, age at diagnosis), clinical (BMI, cabergoline dose, surgery, symptoms at diagnosis), hormonal (PRL, pituitary function, hormone replacement therapy) and radiological parameters at diagnosis and during follow-up (major diameter, cranio-caudal, antero-posterior and latero-lateral diameters, adenoma volume, cavernous sinus invasion, optic chiasm compression, delta of adenoma diameter change) were collected. Subjects with ≥20% reduction in volume or major diameter were defined as responders. High-responders were those with ≥50% reduction.
Results: Sixty-two patients (median age 37 years, IQR 26.5–45.3) were included; most of the patients were female (62.9%), who had also more frequently microadenoma (82.6%, P < 0.0001). The median dose of cabergoline was 1.0 mg/week (0.5–1.4 mg/week). Forty-eight subjects (77.4%) were responders, 35 of whom (56.5%) were high responders. Response to therapy did not differ between sex or micro/macro lesions. Male patients and macroprolactinomas had higher early response rates (6–12 months) during follow-up (P<0.05). An early (6-month) reduction in adenoma volume predicted a long-term shrinkage. Age, basal prolactin and cortisol levels were independent predictors of radiological outcomes.
Conclusions: Adenoma shrinkage and decrease in PRL levels can be useful predictors in the long-term workup management of prolactin-secreting lesions. They should be validated to drive early surgical intervention.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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