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Prolactinoma surgery.

M Jan1, H Dufour, T Brue

  • 1Department of Neurosurgery, Bretonneau Regional University Teaching Hospital, 2 Bd Tonnellé, 37044 Tours cedex, France.

Annales D'Endocrinologie
|May 22, 2007
PubMed
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Surgery offers a potential cure for prolactinomas when medical treatments fail or are not tolerated. While effective for microprolactinomas, relapse is possible, and macroprolactinomas rarely achieve a complete cure.

Area of Science:

  • Neurosurgery
  • Endocrinology
  • Oncology

Background:

  • Prolactinomas are pituitary tumors that secrete prolactin.
  • Dopamine agonists are the primary medical treatment.
  • Surgery is typically reserved for specific cases.

Purpose of the Study:

  • To review the role of surgery in managing prolactinomas.
  • To compare surgical outcomes for micro- and macroprolactinomas.
  • To outline indications for surgical intervention.

Main Methods:

  • Review of existing literature on prolactinoma surgery.
  • Analysis of surgical approaches including selective adenomectomy, transsphenoidal, and transfrontal procedures.
  • Evaluation of treatment outcomes, including cure rates, relapse, morbidity, and mortality.

Related Experiment Videos

Main Results:

  • Selective adenomectomy for microprolactinomas achieves 75-90% prolactin normalization with low morbidity/mortality.
  • Relapse rates after surgery for microprolactinomas can reach up to 20%.
  • Complete cure is unlikely for macroprolactinomas due to invasive extension; surgery is for resistant cases or complications.

Conclusions:

  • Surgery is a viable second-line treatment for prolactinomas, particularly microprolactinomas, offering definitive cure in many cases.
  • Surgical outcomes depend on tumor size and invasiveness, with higher success rates for smaller tumors.
  • Indications include drug resistance, intolerance, patient preference for cure, and rare complications like pituitary apoplexy.