Endocrine Abstracts

JOINT1018

Aim: Prolactinoma, a prolactin (PRL)-secreting pituitary tumor, is the most common functioning pituitary adenoma, comprising 40–60% of cases. However, it is rare in childhood and adolescence, accounting for less than 3% of childhood supratentorial tumors. This study evaluates the clinical characteristics, treatment responses, and outcomes of Korean adolescents with prolactinoma at a single center.

Method: This retrospective study included patients diagnosed with prolactinoma at Samsung Medical Center from March 2005 to August 2024. Clinical data, PRL levels, and MRI findings at diagnosis and after treatment with dopamine agonists were analyzed. Outcomes of medical and surgical management were also assessed to determine factors influencing treatment success.

Result: A total of 28 patients (22 female, 6 male) with a median age of 16. 9 years (range: 10. 1–18. 5) were included. Females commonly presented with galactorrhea (50. 0%) and amenorrhea (40. 9%), whereas males had visual deficits (50. 0%) and headaches (50. 0%). Microadenomas (≤ 10 mm) were found in 12 patients, and macroadenomas (> 10 mm) in 16. PRL levels were significantly higher in macroadenomas than in microadenomas (2, 197. 7 vs. 141. 4 ng/mL, p < 0. 001). Panhypopituitarism occurred in 81. 3% of macroadenoma cases vs 8. 3% in microadenomas (P = 0. 008). Surgery was performed in 86% of macroadenoma cases compared to 18% of microadenomas (p < 0. 001). Male gender, PRL levels, and tumor diameter were positively correlated with tumor size. Among 20 patients treated with dopamine agonists, 10 responded positively. Transsphenoidal surgery (TSA) was performed in 18 cases, achieving PRL normalization in 12. Three patients required Gamma Knife Surgery due to resistance, intolerance, or recurrence after TSA.

Conclusion: Adolescent females with prolactinoma are more common, but males more often present with macroprolactinomas and mass effect symptoms. Macroprolactinomas frequently cause panhypopituitarism, necessitating early intervention. Gender differences in prognosis suggest a need for more aggressive treatment in males. Early detection, individualized therapy, and timely hormone replacement are crucial for optimizing long-term outcomes.

Keywords: Prolactinoma, Trannssphenoidal approach, macroprolactinoma