Prolactinoma surgery: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 30: Line 30:
[[Category:Neuroendocrinology]]
[[Category:Neuroendocrinology]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Needs content]]

Revision as of 14:57, 7 September 2015

Prolactinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Prolactinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

ECG

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Prolactinoma surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Prolactinoma surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Prolactinoma surgery

CDC on Prolactinoma surgery

Prolactinoma surgery in the news

Blogs on Prolactinoma surgery

Directions to Hospitals Treating Prolactinoma

Risk calculators and risk factors for Prolactinoma surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Surgery should be considered if medical therapy cannot be tolerated or if it fails to reduce prolactin levels, restore normal reproduction and pituitary function, and reduce tumor size. If medical therapy is only partially successful, this therapy should continue, possibly combined with surgery or radiation treatment.

Surgery

Surgery to remove all or part of the tumor should only be considered if:

  • Medical therapy cannot be tolerated
  • Medical therapy fails to reduce prolactin levels
  • Medical therapy fails restore normal reproduction and pituitary function
  • Medical therapy fails to reduce tumor size.

If medical therapy is only partially successful, it should be continued, possibly combined with surgery or radiation. Most often, the tumor is removed through the nasal cavity. Rarely, if the tumor is large or has spread to nearby brain tissue, the surgeon will access the tumor through an opening in the skull. The results of surgery depend a great deal on tumor size and prolactin levels as well as the skill and experience of the neurosurgeon. The higher the prolactin level before surgery, the lower the chance of normalizing serum prolactin. Serum is the portion of the blood used in measuring prolactin levels. In the best medical centers, surgery corrects prolactin levels in about 80 percent of patients with small tumors and a serum prolactin less than 200 nanograms per milliliter (ng/ml). A surgical cure for large tumors is lower, at 30 to 40 percent. Even in patients with large tumors that cannot be completely removed, drug therapy may be able to return serum prolactin to the normal range-20 ng/ml or less-after surgery. Depending on the size of the tumor and how much of it is removed, studies show that 20 to 50 percent will recur, usually within 5 years[1].

Radiation Therapy

Rarely, radiation therapy is used if medical therapy and surgery fail to reduce prolactin levels. Depending on the size and location of the tumor, radiation is delivered in low doses over the course of 5 to 6 weeks or in a single high dose. Radiation therapy is effective about 30 percent of the time.

References


Template:WikiDoc Sources