Prolactinoma surgery: Difference between revisions
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{{CMG}} {{AE}}{{Faizan}}{{Anmol}} | {{CMG}} {{AE}}{{Faizan}}{{Anmol}} | ||
==Overview== | ==Overview== | ||
Surgery is not the first-line treatment option for patients with [[prolactinoma]]. | Surgery is not the first-line treatment option for patients with [[prolactinoma]]. [[Surgery]] is usually reserved for patients in whom medical therapy fails to reduce the size of the [[tumor]]. | ||
==Surgery== | |||
== | === Indications === | ||
Surgery is indicated in patients if:<ref name="urlProlactinoma | NIDDK">{{cite web |url=https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma |title=Prolactinoma | NIDDK |format= |work= |accessdate=}}</ref> | Medical therapy should be continued even if it is partially successful, possibly combined with surgery or [[radiation]]. Surgery is indicated in patients if:<ref name="urlProlactinoma | NIDDK">{{cite web |url=https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma |title=Prolactinoma | NIDDK |format= |work= |accessdate=}}</ref> | ||
*Medical therapy cannot be tolerated | *Medical therapy cannot be tolerated | ||
*Medical therapy fails to reduce [[ prolactin]] concentration | *Medical therapy fails to reduce [[ prolactin]] concentration | ||
*Medical therapy fails to restore normal reproductive and [[pituitary]] function | *Medical therapy fails to restore normal [[reproductive]] and [[pituitary]] function | ||
*Medical therapy fails to reduce [[tumor]] size | *Medical therapy fails to reduce [[tumor]] size | ||
===Transsphenoidal resection=== | |||
Usually, the [[tumor]] is removed through the [[nasal cavity]]. Rarely, if the tumor is large or has spread to nearby [[Brain|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: | |||
===Transsphenoidal | *Small [[tumors]] (microadenomas) | ||
Usually, the [[tumor]] is removed through the [[nasal cavity]]. Rarely, if the tumor is large or has spread to nearby [[Brain|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 | *Serum [[prolactin]] < 200 ng/ml | ||
Revision as of 13:32, 1 September 2017
Prolactinoma Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Prolactinoma surgery On the Web |
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] Anmol Pitliya, M.B.B.S. M.D.[3]
Overview
Surgery is not the first-line treatment option for patients with prolactinoma. Surgery is usually reserved for patients in whom medical therapy fails to reduce the size of the tumor.
Surgery
Indications
Medical therapy should be continued even if it is partially successful, possibly combined with surgery or radiation. Surgery is indicated in patients if:[1]
- Medical therapy cannot be tolerated
- Medical therapy fails to reduce prolactin concentration
- Medical therapy fails to restore normal reproductive and pituitary function
- Medical therapy fails to reduce tumor size
Transsphenoidal resection
Usually, 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: