[Prolactinoma in man: clinical and histological characteristics].
Prolactinoma usually occurs a small intrasellar tumor in women or as a large tumor in men. To determine whether the predominance of macroprolactinomas in men is due to a delay in diagnosis as has been suggested, or whether there is a sex-related difference in growth rate we conducted a retrospective study in 45 men and 51 women with prolactinomas. Preoperative prolactin level (PRL) was 2,789 573 ng/ml and mean tumor size was 26 2 mm. Prolactin levels and tumor size were significantly higher in women (292 74 ng/ml and 10 1 mm; p<0.01). There was no correlation with age at diagnosis or duration of symptoms. Giant tumors were only observed in men (n=8). Frequency of resistance to bromocriptine (30% vs 5%, p<0.01) and invasive tumors (52% vs 27%, p<0.001) were significantly higher in men than in women. Likewise, proliferation rate was higher for the prolactinomas in men (Ki-67: 2.6 1.1% positive nuclei vs 0.4 0.2%; p=0.08; PCNA: 5.0 2.3% vs 3.7 1.1%). In conclusion, prolactinomas in men are more aggressive than in women. They grow rapidly, often invade the cavernous sinus and are resistant to bromocriptine; proliferation rates can be increased.
Trouillas
J
J
Laboratoire d'Histologie et Embryologie moléculaires, unité INSERM U433, Faculté de médecine Lyon-RTH Laennec, 69372 Lyon cedex 08, France.
Delgrange
E
E
Jouanneau
E
E
Maiter
D
D
Guigard
M P
MP
Donckier
J
J
Perrin
G
G
Jan
M
M
Tourniaire
J
J
D000293:Adolescent; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use; D002455:Cell Division; D004351:Drug Resistance; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D011388:Prolactin / Q000037:antagonists & inhibitors / Q000097:blood; D015175:Prolactinoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D012189:Retrospective Studies; D012727:Sex Characteristics
D006727:Hormone Antagonists; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D001971:Bromocriptine; D011388:Prolactin