Prolactinoma accounts for the majority of pituitary adenomas and can be successfully treated with dopamine agonists. However, data looking at treatment modalities and outcomes are scarce in the South Asian region. This Knowledge can bring new insights into managing prolactinomas in resource-poor settings.
A descriptive cross-sectional study was conducted at the Diabetes and Endocrine Unit at the National Hospital of Sri Lanka to assess clinical characteristics, therapeutic approaches and their outcomes in patients with prolactinoma followed up at a tertiary care center in Sri Lanka. Socio-demographic and clinical data were gathered through an interviewer-administered questionnaire and medical records.
Data was collected from 54 patients and 51.9 % (n=28) were female. The mean age of the population was 43.3 ± 12.98 years. Females had a mean age at presentation of 35.95 ± 13.53 years whereas among males it was 33.32 ± 9.31 years. In females 75%(n=21) presented with headache, 67.8% (n =19) with galactorrhea and 64.2% n=18) with menstrual irregularities. Most males, 88.4% (n=23), presented with visual impairment due to the mass effect, whereas 73% (n=19) presented with headache. Majority of the population had macroprolactinomas (53.7% n=29) with a mean prolactin level of 36015.7 mIU/L. Microprolactinomas accounted for only 29.6% (mean prolactin-5952.87mIU/L) while 16.8% (n =9) had giant prolactinomas (mean prolactin-78588.62 miu/L) 2 patients who had surgery as the first-line treatment (3.7%) failed to achieve remission. 37 patients received cabergoline as first-line treatment and 19 are tumour free. 12 patients received bromocriptine and 8 are tumour-free. 5 received radiotherapy without achieving remission.
Among Sri Lankan patients with prolactinoma ,dopamine agonists as first-line treatment have a good response. However, further studies are recommended to decide on the best treatment strategy in a resource-poor setting like Sri Lanka when current management is shifting towards surgery.