Pituitary prolactinomas in Yaounde: analysis of 36 consecutive cases in the internal medicine unit of the Yaounde reference hospital.

We analysed the epidemiological, clinical, biological, morphological and therapeutic characteristics of 36 cases of pituitary prolactinomas in Yaounde, Cameroun. Diagnosis was made on the basis of neuro-ophtalmological, gynaecological and sexual symptoms associated with quantity determinations of prolactinemia, total testosterone and blood oestrogen, folliculo stimulating hormone and luteining hormone. Expected levels of prolactinemia are above 150 mug/l. Cerebral tomodensitometry and, where possible, magnetic resonance imaging were used. Among the 24 patients on whom a tomodensitometry was performed, 4 male patients presented macroprolactinomas, the remaining 20 patients - mostly female - had microprolactinomas. Macroprolactinomas were found in male patients only, leading to an acute ophtalmological emergency for 2 of them who were operated in Paris-France. All the patients were put on bromocriptine; this molecule has antisecretory and antiproliferative properties, which are very useful in Africa, since surgery is very expensive. Cases of resistance to the molecule exist and new dopaminergic agonists are not yet being used in Cameroon.