A large proportion of prolactin secreting tumours of the pituitary gland are treatable by dopamine agonist drugs. However certain subgroups of these patients are better managed by surgical excision. The indications for surgery in prolactinomas remain controversial and this paper attempts to clarify these with illustrative cases. The factors favouring a surgical approach include poor tolerance of long term medical therapy, progression of visual deficits or recurrence while on medical treatment, cystic change in the tumour with pressure effects, CSF fistula secondary to tumour shrinkage and prophylactic surgery in tumours anticipated to cause CSF leak following medical therapy. The size and invasiveness of the tumour and the prolactin level are also important determinants of treatment planning. The indications for surgery in prolactinomas are discussed and illustrative cases are presented.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Psychological burden in patients with sellar masses under conservative and surgical management.
Neurosurg Rev
January 2025
Department of Neurosurgery, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
The aim of this study was to investigate the level of distress and the quality of life of operated and non-operated patients with pituitary tumors. Patients who presented to a neurosurgical center and two endocrinological services for outpatient follow-up after surgical treatment, as well as those under medical therapy or radiological follow-up without treatment, were invited to participate in the study. Sociodemographic, health-related quality of life and clinical data were assessed.
View Article and Find Full Text PDFA rare case of double pituitary prolactinomas: the diagnostic application of intraoperative ultrasonography and DNA methylation markers.
Arch Endocrinol Metab
January 2025
Henry Ford Health Hermelin Brain Tumor Center Department of Neurosurgery DetroitMI USA Henry Ford Health, Omics Laboratory, Hermelin Brain Tumor Center, Department of Neurosurgery, Detroit, MI, USA.
The aim of this study is to describe the management and evolution of a patient with the rare condition of double lactotroph tumors and assess the role of intraoperative ultrasonography (IOUS) for their detection and methylation-based liquid biopsy for their diagnosis and monitoring. A 29-year-old woman diagnosed with double lactotroph tumors through hormonal and MRI workup underwent surgical resection due to cabergoline intolerance. To detect a tumor missing through visual inspection, IOUS was performed.
View Article and Find Full Text PDFSelective resection of the medial wall of the cavernous sinus in pituitary surgery: results of a prospective single center analysis.
Pituitary
January 2025
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Purpose: Pituitary adenomas, despite their histologically benign nature, can severely impact patients' quality of life due to hormone hypersecretion. Invasion of the medial wall of the cavernous sinus (MWCS) by these tumors complicates surgical outcomes, lowering biochemical remission rates and increasing recurrence. This study aims to share our institutional experience with the selective resection of the MWCS in endoscopic pituitary surgery.
View Article and Find Full Text PDFGonadotropic axis following endoscopic surgery for pituitary neuroendocrine tumor in patients of reproductive age.
Ann Endocrinol (Paris)
January 2025
Department of Endocrinology, Diabetes and Nutrition, Nancy Regional University Hospital, Nancy, France.
Purpose: Pituitary neuroendocrine tumor (PitNET), excluding prolactinoma, often requires endoscopic endonasal surgery (EES). Identifying predictive factors for complications, and particularly rare ones such as hypogonadotropic hypogonadism (HH) that may affect fertility, is challenging. This study investigated de-novo postoperative HH and its potential impact on fertility.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!