A 28-year-old woman presents with galactorrhea, amenorrhea, and infertility for 6 months. Serum prolactin is 180 ng/mL (normal <20). MRI reveals a 6 mm pituitary lesion. Which is the most likely pituitary adenoma type and the first-line treatment?

• A Somatotroph adenoma; transsphenoidal surgery
• B Corticotroph adenoma; ketoconazole therapy
• C Null cell adenoma; transsphenoidal surgery
• D Lactotroph (prolactin) adenoma; dopamine agonist (cabergoline) ✓

Explanation

Prolactinoma is the most common functioning pituitary adenoma and presents with galactorrhea, amenorrhea, and hyperprolactinemia. Dopamine agonists (cabergoline or bromocriptine) are first-line therapy and shrink most microprolactinomas. Surgery is reserved for drug intolerance or resistance. Somatotroph adenomas cause acromegaly. Corticotroph adenomas cause Cushing disease. Null cell adenomas are usually nonfunctioning and present with mass effects.

Reference: Williams Textbook of Endocrinology, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.