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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Published on: January 17, 2018

Debate: Surgery as Initial Therapy for Microprolactinoma.

Mark E Molitch¹, Adam N Mamelak²

¹Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

The Journal of Clinical Endocrinology and Metabolism

|October 1, 2025

Summary

This summary is machine-generated.

Dopamine agonists are standard for prolactinomas, but surgery offers high remission rates for macroprolactinomas. This editorial debates surgery versus medication as a first-line treatment for these pituitary tumors.

Area of Science:

Endocrinology
Neurosurgery
Oncology

Background:

Prolactinomas are the most common pituitary adenomas, often microprolactinomas.

Keywords:

dopamine agonist menopause pituitary adenoma prolactin prolactinoma surgery

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Dopamine agonists (DAs), particularly cabergoline, are the established first-line treatment for macroprolactinomas.

While effective, DAs have limitations including side effects, resistance, and long-term dependency.