Prolatin secreting pituitary adenomas.

Prolactin secreting adenomas are the most frequently (50%) occurring pituitary adenoma. They occur more commonly in women than in men (4:1). Impairment of gonadal function accounts for the predominant symptoms in both sexes. Forty females and ten males with prolactin secreting adenomas were treated with selective adenoma removal by transsphenoidal surgery. Duration of symptoms varied from two months to 25 years. Twenty percent of the women and 100% of the men had invasive adenomas, a tumor that is difficult or impossible to eradicate. The chances of surgically correcting hyperprolactinemia in the female patient was 75% if the preoperative basal prolactin was 200 ng/ml or less, or 71% if the adenoma was non-invasive. The men were more difficult to treat because they all had invasive adenoma. In 50% of the men, prolactin was normalized by surgery. Early recognition of these patients before the adenomas become invasive is needed.