Transsphenoidal microsurgery for pituitary tumors associated with hyperprolactinemia.

Area of Science:

• Neurosurgery
• Endocrinology
• Oncology

Background:

• Hyperprolactinemia is often caused by pituitary tumors.
• Transsphenoidal microsurgery is a common treatment approach.

Purpose of the Study:

• To evaluate the efficacy of transsphenoidal microsurgery for pituitary tumors associated with hyperprolactinemia.
• To assess the impact of surgery on prolactin levels and pituitary-target organ function.

Main Methods:

• Retrospective analysis of 37 patients undergoing transsphenoidal microsurgery.
• Measurement of preoperative and postoperative prolactin levels.
• Assessment of pituitary-target organ axes function before and after surgery.

Main Results:

• Normal postoperative prolactin levels were achieved in 19/26 patients with preoperative prolactin < 200 ng/ml, and 3/11 patients with preoperative prolactin > 200 ng/ml.
• Pituitary-target organ axes function was maintained in 12/13 patients with normal preoperative function.
• Postoperative recovery of deficient axes occurred in 6/13 patients.
• Tumor regrowth was indicated in 4/35 patients despite presumed complete tumor removal.

Conclusions:

• Transsphenoidal microsurgery is the preferred surgical option for most pituitary tumors causing hyperprolactinemia.
• Surgical success in normalizing prolactin levels is dependent on preoperative prolactin concentration.
• Long-term surveillance is necessary to monitor for tumor recurrence.