Prolactinoma surgery
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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] 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 when medical therapy fails to reduce the size of the tumor.
Surgery
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 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