Tiwari Pooja, Saikia Uma K, Baro Abhamoni, Bhuyan Ashok K
Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
Indian J Endocrinol Metab. 2024 May-Jun;28(3):268-272. doi: 10.4103/ijem.ijem_283_23. Epub 2024 Jun 26.
The presentation of macroprolactinomas and response to treatment may vary according to age, sex and tumour characteristics. To analyse clinical phenotype, biochemical and radiological characteristics of macroprolactinomas presenting to a tertiary care centre. A retrospective observational study from January 2018 to December 2022.
Thirty diagnosed cases (18 females, 12 males) of macroprolactinomas were included and followed up for one year.
The most common presentation was headache (73%), visual disturbances (50%), galactorrhoea (33.3%) and loss of libido (26.6%) along with menstrual cycle disturbances (94%), and infertility (55%) in females. Duration of symptoms (2.22 ± 2.87 vs 4.61 ± 3.4 years), tumour size (4.8 ± 2.09 vs 2.75 ± 1.24 cm) and prolactin levels (5153.5 ± 4755.3 vs 1803.5 ± 3785.5 ng/ml) were different significantly between males and females. Good response to medical therapy was observed in 84% of the treatment-naive patients.
Macroprolactinomas in males present with shorter duration of symptoms, larger size, higher prolactin levels and more resistant tumours, emphasizing the need for early diagnosis and aggressive management. Medical therapy remains the treatment of choice irrespective of gender.
大泌乳素瘤的临床表现及对治疗的反应可能因年龄、性别和肿瘤特征而异。分析在三级医疗中心就诊的大泌乳素瘤的临床表型、生化及影像学特征。这是一项2018年1月至2022年12月的回顾性观察研究。
纳入30例确诊的大泌乳素瘤病例（18例女性，12例男性），并随访一年。
最常见的表现为头痛（73%）、视觉障碍（50%）、溢乳（33.3%）和性欲减退（26.6%），女性还伴有月经周期紊乱（94%）和不孕（55%）。男性和女性在症状持续时间（2.22±2.87 vs 4.61±3.4年）、肿瘤大小（4.8±2.09 vs 2.75±1.24 cm）和泌乳素水平（5153.5±4755.3 vs 1803.5±3785.5 ng/ml）方面存在显著差异。84%的初治患者对药物治疗反应良好。
男性大泌乳素瘤的症状持续时间较短、肿瘤较大、泌乳素水平较高且肿瘤更具耐药性，这强调了早期诊断和积极治疗的必要性。无论性别如何，药物治疗仍是首选治疗方法。
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