Giant prolactinoma in adult males

Mouna Elleuch; Yassmine Abdelkafi; Zaineb Fourati; Arous Mohamed Khairi; Yesmine Elloumi; Mouna Mnif; Salah Dhoha Ben; Majdoub Nabila Rekik

doi:10.1530/endoabs.110.EP1215

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Endocrine Abstracts (2025) 110 EP1215 | DOI: 10.1530/endoabs.110.EP1215

ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)

Giant prolactinoma in adult males

Mouna Elleuch ¹ , Yassmine Abdelkafi ¹ , Zaineb Fourati ¹ , Mohamed Khairi Arous ¹ , Yesmine Elloumi ¹ , Mouna Mnif ¹ , Dhoha Ben Salah ¹ & Nabila Rekik Majdoub ¹

Author affiliations

¹Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia

JOINT2367

Introduction: Pituitary adenomas represent 15% of brain tumors, with prolactinomas accounting for 40% of these. Prolactinomas are classified into micro, macro, and giant prolactinomas based on size. Macroprolactinomas and giant prolactinomas are more common in men, often without specific clinical signs, leading to delayed diagnosis.

Methods: We conducted a descriptive and analytical study of 36 men followed at the Endocrinology and Diabetology Department of Hedi Chaker University Hospital in Sfax for prolactin-secreting adenomas. We specifically investigated the characteristics of giant prolactinomas, defined as those with a size greater than 4 cm.

Results: Giant prolactinomas were observed in 11 patients (30.6%). The mean age at diagnosis was 43.6 ± 15.1 years, with extremes ranging from 19 to 75 years. The primary clinical presentations included headaches (86.1%), visual disturbances (69.4%), and sexual dysfunction (47.2%). Hypopituitarism was common, with gonadotropic insufficiency in 63.9% of cases. Imaging revealed significant tumor extensions into suprasellar and lateral regions. The mean prolactin level was 18,662 ± 52,817 ng/ml. Dopamine agonists were the first-line treatment, with surgery reserved for resistant or complicated cases. A positive correlation was observed between tumor size and prolactin levels (rho = 0.658, P < 0.001). Additionally, tumor size was associated with increased risk of hypopituitarism, particularly gonadotropic and thyrotropic insufficiencies. However, no significant correlation was found between tumor size and metabolic parameters such as BMI or waist circumference.

Conclusion: Giant prolactinomas in men present challenges due to their size and nonspecific symptoms, often resulting in delayed diagnosis. Early identification and multidisciplinary management are essential to prevent complications related to vision, endocrine dysfunction, and quality of life.