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Surgery for Prolactinomas to Date.

Michael Buchfelder1, Yining Zhao2, Sven-Martin Schlaffer2

  • 1Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany, michael.buchfelder@uk-erlangen.de.

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|January 31, 2019
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Summary
This summary is machine-generated.

Surgery for prolactinomas is now reserved for specific cases, particularly when medical treatments fail or are not tolerated. Surgical resection offers excellent results for microprolactinomas and aids in managing difficult-to-treat tumors.

Keywords:
Medical treatmentProlactinomaSurgeryTechnical advances

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Prolactinomas, pituitary tumors producing prolactin, were historically treated with surgery.
  • Medical management with dopamine agonists is now the primary treatment for most prolactinomas.

Purpose of the Study:

  • To review the current indications, outcomes, techniques, and complications of surgical interventions for prolactinomas.
  • To delineate the specific situations where surgery remains a viable or necessary option.

Main Methods:

  • Review of existing literature on prolactinoma surgery.
  • Analysis of surgical outcomes, including prolactin normalization and tumor shrinkage.
  • Discussion of patient selection criteria and management strategies.

Main Results:

  • Surgical indications for prolactinomas are now limited to specific scenarios.
  • Surgery can achieve excellent prolactin normalization rates in microprolactinomas.
  • Combined surgical resection and long-term medical treatment improve outcomes for complex cases.

Conclusions:

  • Surgical intervention for prolactinomas is reserved for cases of medical intolerance or insufficient drug efficacy.
  • For microprolactinomas, surgery can be highly effective in normalizing prolactin levels.
  • A combined approach is beneficial for managing challenging prolactinoma cases.