PROLACTINOMA: CONSIDERATIONS IN MALE

Abstract

Prolactinomas are prolactin-secreting pituitary adenomas, being more common in women, but presenting specific characteristics when they appear in men. In general, male prolactinomas tend to be larger in diameter and more aggressive in clinical course. Generally what leads to the diagnosis in men are some of the effects of tumor mass, such as visual disturbances and headaches, and less frequently due to the effects of hyperprolactinemia. Prolactinomas in males can impact cardiovascular and metabolic health, fertility and bone health. The management of prolactinomas in men predominantly involves pharmacotherapy with dopamine agonists, aimed at reducing PRL levels, reversing clinical signs, reducing the tumor, restoring gonadal function and other pituitary hormonal deficiencies, and preventing tumor recurrence or progression. Despite their aggressiveness, these tumors are mostly benign and respond well to treatment and prolactin normalization is achieved in most cases. In summary, although less common in men, prolactinomas present specific and often challenging clinical characteristics in males, requiring therapeutic approaches adapted to their specific needs. Understanding these particularities is essential to improve clinical results and quality of life for male patients.