Prolactinomas: surgical therapy, indications and results

Area of Science:

• Endocrinology
• Neurosurgery
• Reproductive Medicine

Background:

• Prolactinomas are pituitary tumors that overproduce prolactin, leading to hormonal imbalances.
• Treatment options for prolactinomas include surgery, medication (bromocriptine), and radiation therapy.

Purpose of the Study:

• To evaluate the effectiveness of transsphenoidal microsurgery for prolactinomas.
• To compare surgical outcomes with bromocriptine therapy and radiation therapy.

Main Methods:

• Transsphenoidal microsurgical removal of prolactinomas.
• Assessment of prolactin levels, menstrual resumption, and fertility post-surgery.
• Comparison of surgical outcomes with bromocriptine and radiation therapy.

Main Results:

• Transsphenoidal microsurgery highly effective for microadenomas, normalizing prolactin levels and restoring fertility.
• Surgery comparable to bromocriptine for microadenomas regarding prolactin normalization and fertility.
• Bromocriptine more effective than surgery for macroadenomas.
• Radiation therapy reserved for macroadenomas with extensive invasion.

Conclusions:

• Transsphenoidal microsurgery is a safe and effective primary treatment for prolactin-secreting microadenomas.
• Bromocriptine is a valuable alternative and adjunct therapy, particularly for macroadenomas and post-surgical management.
• A multimodal approach considering tumor size and extension is crucial for optimal patient outcomes.