Cited by 411Pituitary Gland Disorders and TreatmentsNeuroendocrine Tumor Research AdvancesGrowth Hormone and Insulin-like Growth Factors

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society International Consensus Statement

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Petersenn, Stephan, Fleseriu, Maria, Casanueva, Felipe F., Giustina, Andrea, Biermasz, Nienke, Biller, Beverly M. K., Bronstein, Marcello, Chanson, Philippe +28 more·2023·Nature Reviews Endocrinology

Abstract

This Consensus Statement from an international, multidisciplinary workshop sponsored by the Pituitary Society offers evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. Epidemiology and pathogenesis, clinical presentation of disordered pituitary hormone secretion, assessment of hyperprolactinaemia and biochemical evaluation, optimal use of imaging strategies and disease-related complications are addressed. In-depth discussions present the latest evidence on treatment of prolactinoma, including efficacy, adverse effects and options for withdrawal of dopamine agonist therapy, as well as indications for surgery, preoperative medical therapy and radiation therapy. Management of prolactinoma in special situations is discussed, including cystic lesions, mixed growth hormone-secreting and prolactin-secreting adenomas and giant and aggressive prolactinomas. Furthermore, considerations for pregnancy and fertility are outlined, as well as management of prolactinomas in children and adolescents, patients with an underlying psychiatric disorder, postmenopausal women, transgender individuals and patients with chronic kidney disease. The workshop concluded that, although treatment resistance is rare, there is a need for additional therapeutic options to address clinical challenges in treating these patients and a need to facilitate international registries to enable risk stratification and optimization of therapeutic strategies.

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  1. [38]38. Kaiser, U. & Ho, K. Pituitary physiology and diagnostic evaluation. In Williams Textbook of Endocrinology (eds Melmed, S., Koenig, R., Rosen, C. J., Auchus, R. J. & Goldfine, A, B.) 184-235 (Elsevier, 2019).

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Authors
Petersenn, S., Fleseriu, M., Casanueva, F. F., Giustina, A., Biermasz, N., Biller, B. M. K., Bronstein, M., Chanson, P., Fukuoka, H., Gadelha, M., Greenman, Y., Gurnell, M., Ho, K. K. Y., Honegger, J., Ioachimescu, A. G., Kaiser, U. B., Karavitaki, N., Katznelson, L., Lodish, M., Maiter, D., Marcus, H. J., McCormack, A., Molitch, M., Muir, C. A., Neggers, S., Pereira, A. M., Pivonello, R., Post, K., Raverot, G., Salvatori, R., Samson, S. L., Shimon, I., Spencer-Segal, J., Vila, G., Wass, J., & Melmed, S.
Affiliations
  • University of Duisburg-Essen (DE)
  • Oregon Health & Science University (US)
  • Universidade de Santiago de Compostela (ES)
  • Vita-Salute San Raffaele University (IT)
  • Leiden University Medical Center (NL)
  • Massachusetts General Hospital (US)
  • Universidade de São Paulo (BR)
  • Université Paris-Saclay (FR)
  • Kobe University Hospital (JP)
  • Tel Aviv University (IL)
  • University of Cambridge (GB)
  • Garvan Institute of Medical Research (AU)
  • University of Tübingen (DE)
  • Medical College of Wisconsin (US)
  • Brigham and Women's Hospital (US)
  • University of Birmingham (GB)
  • Stanford Medicine (US)
  • University of California, San Francisco (US)
  • Cliniques Universitaires Saint-Luc (BE)
  • University College London Hospitals NHS Foundation Trust (GB)
  • Northwestern University (US)
  • St Vincent's Hospital Sydney (AU)
  • Erasmus MC (NL)
  • Amsterdam University Medical Centers (NL)
  • University of Naples Federico II (IT)
  • Mount Sinai Health System (US)
  • Johns Hopkins University (US)
  • Mayo Clinic in Florida (US)
  • University of Michigan (US)
  • Medical University of Vienna (AT)
  • Churchill Hospital (GB)
  • Cedars-Sinai Medical Center (US)
Corresponding author
Petersenn, Stephan
Venue
Nature Reviews Endocrinology
Published
2023-09-05
Volume
19
Issue
12
Pages
722-740
ISSN
  • 1759-5029 (ISSN-L)
  • 1759-5037
OpenAlex
W4386449135
Cited by
411
References
193
Citations by year
2026: 145 · 2025: 137 · 2024: 119 · 2023: 8
FWCI
14.68
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (publishedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
  • Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, cc-by)
Funders
  • Cedars-Sinai Medical Center
  • University College London Hospitals NHS Foundation Trust
  • Wellcome / EPSRC Centre for Interventional and Surgical Sciences
  • Engineering and Physical Sciences Research Council
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Keywords
prolactinoma, prolactin-secreting pituitary adenoma, hyperprolactinemia, dopamine agonist therapy, surgical treatment, radiotherapy, giant prolactinoma, treatment resistance, pituitary imaging
MeSH terms
Adolescent, Child, Diagnostic Imaging, Female, Humans, Hyperprolactinemia, Pituitary Neoplasms, Pregnancy, Prolactin, Prolactinoma, Dopamine Agonists

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