Experience in the Treatment of Male Prolactinomas: A Single-Center, 10-Year Retrospective Study.

Introduction: Male prolactinomas are uncommon and typically macroadenomas with difficult treatment and management. The purpose of this study was to summarize the treatment and management experiences of 254 male prolactinoma patients at a single center.

Methods: This was a 10-year retrospective study conducted at a single center. A total of 254 male prolactinoma patients were included. Clinical data for all subjects were collected using an electronic medical record system.

Results: A total of 254 male patients with prolactinoma were studied. Their median age at onset was 28.8 years, and median disease duration was 28.5 months. The median PRL levels were 582.0 ng/mL at diagnosis. Their median maximum tumor diameter was 23.0 mm, with macroadenoma accounting for the majority (76.7%). After treatment, the biochemical remission rate with monotherapy was 36.6%, but significantly increased to 60.6% with multidisciplinary treatment (p < 0.001). Knosp 0-2 patients had significantly higher rates of biochemical remission compared to Knosp 3-4 (all p < 0.05). In addition, the maximum diameter of adenoma (B = -0.110, p = 0.008) and cavernous sinus invasion (B = -1.741, p = 0.023) were negatively correlated with postoperative biochemical remission. The maximum diameter of the adenoma (B = - 0.131, p < 0.001) was a negative correlation factor, while treatment duration (B = 0.034, p = 0.002) was a positive correlation factor for biochemical response to medication.

Conclusion: Male prolactinoma has a low biochemical remission rate when treated alone, but multitherapy can improve it even more. Surgery may also be considered for male prolactinoma with a micro, and noninvasive tumor after a thorough evaluation.