Abstract
Abstract
Prolactinomas in the transition age present unique challenges; treatment strategies and long‐term outcomes in this population remain incompletely characterised. This is a multicentre, retrospective study of 110 consecutive patients (33 males) with prolactinomas, aged 15–25 years, across five Italian referral centres (2010–2025). Clinical, hormonal, radiological, and treatment‐related parameters were assessed at diagnosis and at follow‐up. At diagnosis, the median age was 20 years; median prolactin 177 ng/mL [49–6646]; 55% of patients had micro‐tumours. Male patients presented with larger tumours, higher prolactin levels, and greater invasiveness (
p
p
= .040) and shorter treatment duration (OR 0.95/month,
p
= .050), the latter showed 93% sensitivity for recurrence at 45.5 months. Adverse events occurred in 12%, leading to treatment discontinuation in 6%. Surgery was required in 17%, achieving long‐term remission in 31%, while 21% of surgical cases required radiotherapy. At last follow‐up (median 72 months), 73% remained on cabergoline while 25% achieved complete radiological resolution. Transition‐age prolactinomas demonstrate high cabergoline resistance rates and frequent recurrence after discontinuation. Treatment duration ≥45.5 months before withdrawal may reduce recurrence risk. Surgical remission is achievable, especially in non‐invasive tumours, although multimodal therapy is often required for disease control.