Prolactinoma: The Daily PANCE Blueprint

The answer is D. Prolactinoma

A pituitary adenoma is usually a very slow-growing, benign tumor that comes from cells in the pituitary gland. It is the third most common intracranial tumor. Pituitary masses can either be functional (hypersecretion of hormones), hypofunctional (hyposecretion of hormones) or nonfunctional. Clinical features include visual defects (the suprasellar extension of the tumor can compress on the optic chiasm; leading to bitemporal hemianopsia), headaches, signs of hormone deficiencies, and possibly other neurological findings. MRI with gadolinium is the best diagnostic test for diagnosing tumors. Hormone levels should be ordered: prolactin, IGF-1, ACTH, 24-hour urinary free cortisol LSH, FSH, TSH, free TR, b-hGC, etc. Management for prolactinomas is medications (dopamine agonists aka bromocriptine or cabergoline). For symptomatic or medication-resistant tumors, transsphenoidal surgery should be considered.