Institute of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel,
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
Neuroendocrinology. 2019;109(1):51-56. doi: 10.1159/000495184. Epub 2018 Nov 7.
Prolactin-secreting adenomas (prolactinomas) are the most common secreting adenomas of the pituitary. Microprolactinomas (diameter <10 mm) are frequently diagnosed in women, whereas macroprolactinomas (maximum diameter ≥10 mm) are generally seen in men. Most macroprolactinomas measure between 10 and 40 mm. Giant prolactinomas, measuring >40 mm, are rare, accounting for only 1-5% of all prolactinomas. Although generally benign, giant prolactinomas are aggressive and invasive, extending into the suprasellar region and also involving the cavernous sinuses. The optic chiasm is frequently involved, which leads to visual damage, and patients occasionally suffer from ophthalmoplegia. Long-term (usually lifetime) therapy with high-dose dopamine agonists (cabergoline or bromocriptine), together with pituitary surgery in some cases and radiotherapy if required, can achieve biochemical remission, tumor control, and clinical improvement in most patients.
催乳素分泌腺瘤（泌乳素瘤）是最常见的垂体分泌腺瘤。微腺瘤（直径<10mm）常发生于女性，而大腺瘤（最大直径≥10mm）则多见于男性。大多数大腺瘤的直径在 10 至 40mm 之间。直径>40mm 的巨大泌乳素瘤很少见，仅占所有泌乳素瘤的 1-5%。虽然通常为良性，但巨大泌乳素瘤具有侵袭性，向鞍上区域延伸，并累及海绵窦。视交叉经常受累，导致视觉损伤，患者偶尔还会出现眼肌麻痹。大多数患者可通过长期（通常为终身）应用大剂量多巴胺激动剂（卡麦角林或溴隐亭），联合垂体手术，必要时联合放疗，实现生化缓解、肿瘤控制和临床改善。
