Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p < 0.001), female sex (p < 0.001), long delay in consultation (p < 0.001) and a microadenoma (p < 0.001). Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative complications.
Fernandez, A., Karavitaki, N. and Wass, J.A.H. (2010) Prevalence of Pituitary Adenomas: A Community-Based, Cross-Sectional Study in Banbury (Oxfordshire, UK). Clinical Endocrinology, 72, 377-382. https://doi.org/10.1111/j.1365-2265.2009.03667.x
[3]
Daly, A.F., Rixhon, M., Adam, C., et al. (2006) High Prevalence of Pituitary Adenomas: A Cross-Sectional Study in the Province of Liege, Belgium. The Journal of Clinical Endocrinology & Metabolism, 91, 4769-4775. https://doi.org/10.1210/jc.2006-1668
[4]
Kontogeorgos, G., Horvath, E., Kovacs, K., et al. (2005) Morphologic Changes of Prolactin-Producing Pituitary Adenomas after Short Treatment with Dopamine Agonists. Acta Neuropathologica, 111, 46-52. https://doi.org/10.1007/s00401-005-1111-8
[5]
Diop, A.G., Ndiaye, M.M., Ndiaye, I.P., et al. (1990) Les adénomes à prolactine à Dakar. Dakar Médical, 35, 168-176.
[6]
Raappana, A., Koivukangas, J., Ebeling, T. and Pirila, T. (2010) Incidence of Pituitary Adenomas in Northern Finland in 1992-2007. The Journal of Clinical Endocrinology & Metabolism, 95, 4268-4275. https://doi.org/10.1210/jc.2010-0537
[7]
Fontana, E. and Gaillard, R. (2009) Epidemiology of Pituitary Adenoma: Results of the First Swiss Study. Revue Médicale Suisse, 5, 2172-2174.
[8]
Gruppetta, M., Mercieca, C. and Vassallo, J. (2013) Prevalence and Incidence of Pituitary Adenomas: A Population-Based Study in Malta. Pituitary, 16, 545-553. https://doi.org/10.1007/s11102-012-0454-0
[9]
Agustsson, T.T., Baldvinsdottir, T., Jonasson, J.G., et al. (2015) The Epidemiology of Pituitary Adenomas in Iceland, 1955-2012: A Nationwide Population-Based Study. European Journal of Endocrinology, 173, 655-664. https://doi.org/10.1530/EJE-15-0189
[10]
Day, P.F., Loto, M.G., Glerean, M., et al. (2016) Incidence and Prevalence of Clinically Relevant Pituitary Adenomas: Retrospective Cohort Study in a Health Management Organization in Buenos Aires, Argentina. Archives of Endocrinology and Metabolism, 60, 554-561. https://doi.org/10.1590/2359-3997000000195
[11]
Eloundou, N.J., Eyenga, V.C., Ngowe Ngowe, M., Atangana, R. and Sosso, M.A. (2009) Les adénomes hypophysaires. Etude d’une série chirurgicale de 16 cas à Yaoundé Cameroun. African Journal of Neurological Sciences, 28, 55-60.
[12]
Abodo, J., Haidara, A., Koffi, D., et al. (2016) Profil des adénomes hypophysaires en Afrique subsaharienne à propos de 38 cas. Annales d’Endocrinologie, 77, 368-369. https://doi.org/10.1016/j.ando.2016.07.381
[13]
Malik, S., Hussain, S.Z., Basit, R., et al. (2014) Demographic Characteristics, Presentations and Treatment Outcome of Patients with Prolactinoma. Journal of Ayub Medical College Abbottabad, 26, 269-274.
[14]
Mayanda, O.R.L., Ignaleamoko, T.G.S.P., Ekouele, M.H.B., et al. (2021) Prise en Charge des Adénomes Hypophysaires à Prolactine au Centre Hospitalier et Universitaire de Brazzaville. Health Sciences and Disease, 22, 68-73.
[15]
Le Guillou, A.C., Soto-Ares, G., Merlen, E., et al. (2013) Hyperprolactinémie secondaire à un micro-adénome, à un macro-adénome enclos ou à une hyperprolactinémie primaire idiopathique traitée par agonistes dopaminergiques: devenir des patients après plusieurs fenêtres thérapeutiques. Annales d’Endocrinologie, 74, 261. https://doi.org/10.1016/j.ando.2013.07.085
[16]
Ftouhi, B., Chihaoui, M., Maazoun, I., et al. (2005) Traitement médical des adénomes ā prolactine: ā propos de 108 cas. Annales d’Endocrinologie, 66, 460. https://doi.org/10.1016/S0003-4266(05)81983-3
[17]
Bjune, J.I., Stromland, P.P., Jersin, R.A., Mellgren, G. and Dankel, S.N. (2022) Metabolic and Epigenetic Regulation by Estrogen in Adipocytes. Frontiers in Endocrinology, 13, Article 828780. https://doi.org/10.3389/fendo.2022.828780
[18]
Fukuhara, N., Nishiyama, M. and Iwasaki, Y. (2022) Update in Pathogenesis, Diagnosis, and Therapy of Prolactinoma. Cancers, 14, Article 3604. https://doi.org/10.3390/cancers14153604
[19]
Gürlek, A., Karavitaki, N., Ansorge, O. and Wass, J.A.H. (2007) What Are the Markers of Aggressiveness in Prolactinomas? Changes in Cell Biology, Extracellular Matrix Components, Angiogenesis and Genetics. European Journal of Endocrinology, 156, 143-153. https://doi.org/10.1530/eje.1.02339
[20]
Elfeleh, E., Bchir, N., Rojbi, I., et al. (2016) Evolution des macroprolactinomes sous traitement médical. Annales d’Endocrinologie, 77, 339. https://doi.org/10.1016/j.ando.2016.07.275
[21]
Nishioka, H., Haraoka, J. and Akada, K. (2003) Growth Potential of Prolactinomas in Men: Is It Really Different from Women? Surgical Neurology, 59, 386-390. https://doi.org/10.1016/S0090-3019(03)00012-0
[22]
Kars, M., Dekkers, O.M., Pereira, A.M. and Romijn, J.A. (2010) Update in Prolactinomas. The Netherlands Journal of Medicine, 68, 104-112.
[23]
Irfan, H., Shafiq, W., Siddiqi, A.I., et al. (2022) Prolactinoma: Clinical Characteristics, Management and Outcome. Cureus, 14, e29822. https://doi.org/10.7759/cureus.29822
[24]
Espinosa, E., Sosa, E., Mendoza, V., et al. (2016) Prolactinomes géants: sont-ils vraiment différents des macroprolactinomes ordinaires? Endocrine, 52, 652-659. https://doi.org/10.1007/s12020-015-0791-7
[25]
Colao, A., Vitale, G., Cappabianca, P., et al. (2004) Outcome of Cabergoline in Men with Prolactinoma: Effets of a 24-Mounth Treatment on Prolactin Levels, Tumor Mass, Recovery of Pituitary Function, and Semen Analysis. The Journal of Clinical Endocrinology & Metabolism, 89, 1704-1711. https://doi.org/10.1210/jc.2003-030979
