AI Article Synopsis
- Surgery is no longer the primary treatment for prolactinomas according to current guidelines, yet it's still important for certain cases, particularly those with complications or resistant to medication.
- The study analyzed 12 patients who underwent endoscopic transsphenoidal surgery for prolactinomas between 2013 and 2022, focusing on surgical indications, outcomes, and complications.
- Results showed that most patients had prior treatment with dopamine agonists and experienced complications like transient diabetes insipidus, with surgery effectively recommended for those with neurological symptoms or treatment failures.
Article Abstract
Introduction: Surgery has lost a lot of ground as the main therapy of most prolactinomas as it is clear from the current guidelines in most prolactin secreting adenomas, even in the setting of optic compression. However, we believe that surgery is still an important part in the treatment of this type of adenomas. This study is aimed to define what is the role of pituitary surgery in the current setup of prolactinoma management.
Material And Methods: In this retrospective, single-center study we analyzed 12 consecutive patients who underwent primary endoscopic transsphenoidal surgery for prolactinomas, between 2013 and 2022. Surgical indication, previous dopamine agonist (DA) treatment, remission rates, surgical complications, pituitary function and imagistic appearance are presented.
Results: Of the 12 patients included, 4 had giant PRL and 8 macroadenomas, while 9 of them had previous DA treatment. The main surgical indication was pituitary apoplexy in 5 patients followed by CSF leak after DA treatment, 3 cases, and DA resistance in 3 cases. The main surgical complications were transitory diabetes insipidus in 7 cases. Normalization of prolactin levels was achieved in 2 patients.
Conclusions: Surgical intervention should be strongly considered in all patients with neurologic symptoms referable to the lesion, resistance to medical therapy, other treatment failure or with complications after DA treatment. The endoscopic endonasal surgery offers good surgical outcomes with low rates of surgical complications and should remain an open option for specific cases.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449243 | PMC |
| http://dx.doi.org/10.4183/aeb.2024.65 | DOI Listing |
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