Prolactinoma surgery: Difference between revisions

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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]].
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. 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<ref>http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx</ref>.
The results of surgery depend 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. 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). 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]].


== References ==
== References ==

Revision as of 20:34, 10 September 2015

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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. If medical therapy is only partially successful, this therapy should continue, possibly combined with surgery or radiation treatment.

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 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. 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). 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.

References


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