Prolactinoma

Pituitary apoplexy

Surgery

Multimodal therapy

Pituitary adenoma

Dopamine

Transsphenoidal surgery

Prolactin

Internal medicine

Hormone

Adenoma

Medicine

General surgery

Neurosurgery Clinics of North America

Prolactinomas are the most common functional pituitary adenoma. Many prolactinomas can be treated with medication, but all patients should be evaluated at a neuroendocrine center including experienced neurosurgeons trained in transsphenoidal surgery. Surgery for prolactinomas is feasible and can be performed with low morbidity. Patients never previously treated with dopamine agonists should be considered for surgery if they have neurologic deficits, pituitary apoplexy, an uncertain diagnosis, or a significantly cystic prolactinoma. Patients previously treated with dopamine agonists should be considered for surgery in cases of intolerance or resistance. Recurrent and aggressive prolactinomas often require multimodal therapy.

The Role of Surgery in the Management of Prolactinomas