{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:35:59Z","timestamp":1777372559866,"version":"3.51.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterise distinctive clinical features of giant prolactinomas in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A multicentre, retrospective case series and literature review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected data from 15 female patients with a pituitary tumour larger than 4\u200acm and prolactin levels above 1000\u200a\u03bcg\/l and identified 19 similar cases from the literature; a gender-based comparison of the frequency and age distribution was obtained from a literature review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial PubMed search using the term \u2018giant prolactinomas\u2019 identified 125 patients (13 women) responding to the inclusion criteria. The female:male ratio was 1:9. Another six female patients were found by extending the literature search, while our own series added 15 patients. The median age at diagnosis was 44 years in women compared with 35 years in men (<jats:italic>P<\/jats:italic>&lt;0.05). All cases diagnosed before the age of 15 years were boys. In women (<jats:italic>n<\/jats:italic>=34), we observed a minor peak incidence during the third decade of life and a major peak during the fifth decade. Amenorrhoea was a constant feature with seven cases of primary amenorrhoea. In eight women with onset of secondary amenorrhoea before the age of 40 years, the diagnosis was made 2\u201331 years later (median 9 years) and in all but one because of tumour pressure symptoms. The prolactin levels were above 10\u200a000\u200a\u03bcg\/l in 15\/34 and misdiagnosis due to \u2018hook effect\u2019 occurred in two of them. Eighteen patients were treated with cabergoline; standard doses (&lt;2.0\u200amg\/week) were able to normalise prolactin in only 4\/18 patients, and 7\/18 patients were resistant to weekly doses ranging from 3.0 to 7.0\u200amg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Giant prolactinomas are rare in women, often resistant to dopamine agonists and seem to be distributed in two age groups, with a larger late-onset peak.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-13-0503","type":"journal-article","created":{"date-parts":[[2013,10,3]],"date-time":"2013-10-03T01:16:00Z","timestamp":1380762960000},"page":"31-38","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":59,"title":["Giant prolactinomas in 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