Prolactinoma surgery

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

Overview

Surgery is indicated in patients if medical therapy cannot be tolerated or if it fails to reduce prolactin levels, restore normal reproduction and pituitary function, and reduce tumor size.

Surgery

Surgery is indicated in patients if:

• Medical therapy cannot be tolerated
• Medical therapy fails to reduce prolactin levels
• Medical therapy fails to 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.

Transsphenoidal Resection

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 on tumor size and prolactin concentrations. Surgery corrects prolactin concentrations in about 80 percent of patients with:

• Small tumors (microadenomas)
• Serum prolactin less than 200 nanograms per milliliter (ng/ml)

References

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