Related Experiment Video
Updated: Jul 31, 2025
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
19.0K
Surgical Management of Giant Prolactinomas: A Descriptive Study.
Michelle D Lundholm1, Divya Yogi-Morren1, Kevin M Pantalone1
1Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, OH, USA.
International Journal of Endocrinology
|May 5, 2023
Summary
Surgery for giant prolactinomas (GPs) is uncommon and often incomplete, necessitating further treatment. While remission is achievable, pituitary function recovery is rare, highlighting the need for further research into optimal GP management.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Giant prolactinomas (GPs) are large pituitary tumors (>4 cm) resistant to dopamine agonist monotherapy.
- Data on surgical management of GPs is limited, necessitating further investigation.
Purpose of the Study:
- To describe the institutional experience with surgical management of giant prolactinomas.
- To evaluate the outcomes of surgical intervention for GPs, including remission rates and pituitary function.
- To identify challenges and potential improvements in surgical GP treatment.
Main Methods:
- A retrospective single-center analysis of patients who underwent surgery for GP between 2003 and 2018.
- Inclusion of demographic, clinical, laboratory, and radiographic data, along with operative and pathology reports.
- Descriptive statistical analysis of perioperative management and clinical outcomes.
Main Results:
- Eight patients with GP underwent surgery, with a median tumor size of 6 cm and median prolactin level of 2,500 µg/L.
- Transsphenoidal surgery was performed in six patients due to DA resistance/intolerance; two had craniotomy for missed diagnosis.
- No complete tumor resections were achieved; all patients required adjuvant DA therapy, and two underwent additional craniotomies. Pituitary axes did not recover, and postoperative deficits were common. Remission (prolactin normalization) occurred in 63% of patients on DA therapy post-surgery.
Conclusions:
- Surgical resection of GPs is infrequently performed, typically incomplete, and requires adjuvant therapy.
- Pituitary function recovery is uncommon after surgery for GPs.
- Further multi-institutional or registry studies are needed to establish optimal management guidelines for GPs.
