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It is speculated that in males low level of ER could increase STAP2 expression and be involved in the aggressiveness of male PRLomas ( 4 Diagnosis 4.1 Biochemical diagnosis Many factors, involving physiological ones, can result in hyperprolactinemia ( Due to the possibility of mixed secretion of GH and PRL, insulin-like growth factor-1 (IGF-1) assessment is recommended for patients with PRLomas at diagnosis, while its long-term monitoring is not recommended ( 4.2 Radiological diagnosis Men tend to develop larger diameter tumors which, compared to women, are more likely to infiltrate the cavernous sinus ( Computer tomography (CT) also has its role in the diagnosis of patients with PRLomas, useful in visualizing calcifications or cellular floor bone defects ( 5 Clinical manifestations Diagnosis of PRLoma among men is made later than in women ( Rare complication of treatment is CSF leakage ( It was also found that in boys macroPRLomas are more likely to affect puberty than in girls ( The impact of lactotroph tumors on mens health is summarized in Figure 2

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5fi and Supplementary Fig

There is also a concern about the possibility of estrogen-induced malignant transformation in residual endometriosis implants