ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1668255
Cystic Versus non-Cystic Prolactinoma: Clinical, Hormonal, Radiological, and Remission Outcomes in Basrah
Provisionally accepted
Khulood Abed Reman*
Haider Ayad Alidrisi
Ali Hussain Ali Alhamza
Hassan Falah Alobaidy
Abbas Ali Mansour- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), University of Basrah, Basrah, Iraq, Basrah, Iraq
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Prolactinomas are the most common functional pituitary adenomas. Cystic prolactinomas, characterized by substantial cystic components on magnetic resonance imaging (MRI) scans, may exhibit different clinical behaviors and treatment outcomes. The aim of this study was to compare the clinical, hormonal, and radiological characteristics, and identify predictors of remission in patients with cystic versus non-cystic prolactinomas .The aim of the study was to compare the clinical, hormonal, and radiological features and outcomes of cystic versus non-cystic prolactinomas treated at Faiha Specialized Diabetes, Endocrine and Metabolism Center, a tertiary endocrine center in Basrah, Iraq. Methods: This retrospective cohort study included 196 patients who were diagnosed with prolactinoma between January 2010 and January 2024. The patients were categorized into cystic (n=46) and non-cystic (n=150) groups based on their MRI characteristics. Data on clinical presentation, hormonal levels, imaging findings, treatment response, and remission predictors were analyzed. Results: Patients with cystic prolactinomas were younger and more likely to experience headaches. Lower follicular stimulating hormone levels were also observed in this group. Clinical symptom improvement over time did not differ significantly between the cystic and non-cystic prolactinomas at any follow-up interval. Prolactin levels declined similarly in both groups, and the percentage of patients who achieved a reduction in adenoma diameter did not differ significantly between the groups at any follow-up period. Remission rate was associated with lower baseline prolactin levels, early tumor shrinkage, and initial transsphenoidal surgery. Conclusion: Cystic morphology in prolactinomas does not compromise treatment response. Predictors of early remission can guide management strategies. Surgical intervention remains pivotal in selected cases.
Keywords: pituitary adenoma, Cystic prolactinoma, non-cystic prolactinoma, dopamine agonist, Transsphenoidal surgery
Received: 17 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Reman, Alidrisi, Alhamza, Alobaidy and Mansour. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Khulood Abed Reman, khuloodabed990@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.