Prolactinoma surgery: Difference between revisions
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Surgery is indicated in patients if: | Surgery is indicated in patients if: | ||
*Medical therapy cannot be tolerated | *Medical therapy cannot be tolerated | ||
*Medical therapy fails to reduce [[ prolactin]] | *Medical therapy fails to reduce [[ prolactin]] concentration | ||
*Medical therapy fails to restore normal reproduction and [[pituitary]] function | *Medical therapy fails to restore normal reproduction and [[pituitary]] function | ||
*Medical therapy fails to reduce tumor size | *Medical therapy fails to reduce tumor size | ||
If medical therapy is only partially successful, | If medical therapy is only partially successful, medical therapy should be continued, possibly combined with surgery or [[radiation]]. | ||
===Transsphenoidal Resection=== | ===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 | 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 approximately 80% of patients with: | ||
*Small tumors (microadenomas) | *Small tumors (microadenomas) | ||
*Serum [[prolactin]] | *Serum [[prolactin]] < 200 ng/ml | ||
== References == | == References == | ||
Revision as of 17:18, 15 September 2015
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Prolactinoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Prolactinoma surgery On the Web |
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American Roentgen Ray Society Images of 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 is not the first-line treatment option for patients with prolactinoma. Surgery is usually reserved for patients when medical therapy fails to reduce the size of the tumor.
Surgery
Surgery is indicated in patients if:
- Medical therapy cannot be tolerated
- Medical therapy fails to reduce prolactin concentration
- Medical therapy fails to restore normal reproduction and pituitary function
- Medical therapy fails to reduce tumor size
If medical therapy is only partially successful, medical therapy 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 approximately 80% of patients with:
- Small tumors (microadenomas)
- Serum prolactin < 200 ng/ml