Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. The pathophysiological mechanism of hyperprolactinemia-induced gonadotropic failure involves kisspeptin neurons. Prolactinomas in males are larger, more invasive and less sensitive to dopamine agonists (DAs). Macroprolactin, responsible for pseudohyperprolactinemia is a frequent pitfall of prolactin assay. DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.

中文翻译：

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泌乳素瘤的流行病学，诊断和治疗：新旧。

泌乳素瘤的患病率和发病率约为每100,000人中有50例，每100,000 /年中有3-5个新病例。高泌乳素血症引起的促性腺功能衰竭的病理生理机制涉及kisepteptin神经元。男性泌乳素瘤更大，更具侵袭性，并且对多巴胺激动剂（DAs）的敏感性较低。导致泌乳激素过多症的大泌乳素是泌乳素检测的一个常见陷阱。DA仍然是大多数泌乳素瘤的主要治疗方法，但由于外科技术的进步和微泌乳素瘤的成功率高，以及长期DA治疗的一些低估的副作用（如冲动控制障碍），神经外科手术已引起人们的兴趣或生活质量受损。最新数据显示，DAs对催乳素瘤患者心脏瓣膜的可疑影响令人放心。