Management of selected patients with hyperprolactinaemia by partial hypophysectomy

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Prolactinomas are common pituitary tumors causing hyperprolactinemia.
• Surgical intervention is a treatment option for prolactinomas.

Purpose of the Study:

• To evaluate the efficacy of pituitary surgery in patients with prolactinomas.
• To assess the long-term outcomes of surgical treatment for prolactinomas.

Main Methods:

• Retrospective analysis of 35 patients with prolactinomas who underwent pituitary surgery.
• Assessment of postoperative prolactin levels, symptom resolution, and pregnancy rates.
• Correlation of surgical outcomes with tumor size and preoperative prolactin concentrations.

Main Results:

• 26 out of 35 patients achieved normal prolactin levels and symptom alleviation post-surgery.
• Seven women achieved nine normal pregnancies, resolving infertility issues.
• Tumor size and preoperative prolactin levels significantly impacted normalization rates, with smaller tumors and lower concentrations yielding better results.
• No recurrence of hyperprolactinemia was observed in patients with normalized prolactin levels six weeks post-surgery, even in those with macroprolactinomas.

Conclusions:

• Partial hypophysectomy is an effective and acceptable alternative treatment for selected patients with prolactinomas.
• Surgical outcomes are influenced by tumor characteristics, highlighting the importance of patient selection.
• Sustained normalization of prolactin levels post-surgery indicates long-term remission.