Impact of Tumor Size on Prolactinoma Characteristics and Treatment Outcomes: A Study of a Tunisian Cohort

<b>Issues:</b> The clinical and paraclinical characteristics of prolactinomas differ mainly according to sex and tumor size. Drug treatment with dopamine agonists (ADs) has a crucial role in the management of prolactinomas. The use of surgery also has its indications. <b>Purpose of the work:</b> We aimed to establish the therapeutic strategy and the follow-up profiles of prolactinoma while analyzing the predictive factors of remission; we also looked for correlations between the size of the prolactinoma and the various clinical and paraclinical parameters. <b>Materials and methods:</b> This was a retrospective, descriptive, and analytical study of 77 cases of prolactinomas collected and monitored at the endocrinology and diabetology department of the Hedi Chaker CHU in Sfax between 2000 and 2017. Our patients were divided into three groups according to the size of their prolactinomas. Statistical correlations were sought between tumor size and clinical and biological parameters. <b>Results:</b> The mean age of our patients was 38.3 ± 14.2 years. The sample comprised 51 women (66.2%) and 26 men (33.7%). Anterior pituitary syndrome was observed in 75.3% of cases. The number of antehypophyseal deficits was significantly correlated with tumor size. Comparing the three groups, we noted that age, discovery circumstances, metabolic parameters, hypopituitarism, and pituitary extensions on imaging were significantly different. Therapeutically, our results showed that the favorable evolution of prolactinomas was correlated with tumor size and the duration of treatment. <b>Conclusions:</b> Tumor size appears to be a cornerstone in hormonal and radiological interpretation on the one hand and in the therapeutic decision on the other.