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Prolattinoma in gravidanza


ABSTRACT
{ITA} Il prolattinoma può presentarsi come micro (<10 mm), o come macroadenoma. L’iperprolattinemia provoca disturbi del ciclo mestruale e infertilità. La terapia medica con dopamino-agonisti è il trattamento di prima scelta e può normalizzare la prolattina, ripristinare la fertilità e ridurre le dimensioni dell’adenoma. Il rischio di aumento delle dimensioni del prolattinoma sono maggiori nel macroadenoma non in precedenza trattato (con terapia medica o chirurgica) rispetto al microadenoma e al macroadenoma trattato. Appena la gravidanza è confermata, è consigliabile sospendere la terapia eccetto nei casi in cui l’aumento di volume dell’adenoma possa determinare compressione sulle vie ottiche. - {ENG} Prolactinomas are the most frequent pituitary secreting tumors, and they are classified in microadenoma (<10 mm) or in macroadenoma. Hyperprolactinemia causes infertility and gonadal dysfunction. Medical therapy with dopamino-agonists is the treatment of choice that can normalize prolactin levels, restore fertility, and reduce tumor size. The risk of tumor enlargement during pregnancy is higher in macroadenomas not previously treated (medically or surgically), than in microadenomas and in treated macroadenomas. As soon as pregnancy is confirmed, it is advisable to stop therapy with dopamino-agonists except in those cases with large macroadenomas that can cause visual symptoms.


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