Treatment and long-term follow-up results of prolactin secreting pituitary adenomas

The authors have reported data on a retrospective study, carried out in order to evaluate the short- and the long-term follow-up results of transsphenoidal microsurgery for prolactin-secreting pituitary adenomas; and to point out the indications for an eventual additional bromocriptine treatment. Prior to surgery, the patients were tested according to the study protocol. Patients were grouped differently according to their adenoma size. We found a good correlation between adenoma size and hormonal values. The surgical treatment led to an immediate endocrine cure in 47 patients (48.9%), with the majority occurring in microprolactinomas. Post-operatively, the cure rate was maintained in 45 patients. The Authors deem the transphenoidal microsurgery the therapy of first choice for microadenoma and mesoadenoma treatment, especially whenever there is bromocriptine intolerance. On the contrary, in invasive macroadenomas, bromocriptine is a necessary additional therapy both to shrink large tumors sufficiently for subsequent transsphenoidal approach and in incompletely removed tumors or persistent hyperprolactinemia.