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April2013 Vol.50 Issue:        2        Table of Contents
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Long-Term Outcome of Patients with Prolactinoma

Ayman Elsayed Galhom1, Ahmed Osama2

Department of Neurosurgery1, Neurology2; Suez Canal University; Egypt



ABSTRACT

Background: Prolactinoma is the most common type of pituitary tumors. Primarily, it is treated with dopamine agonists. If medical therapy cannot be tolerated or if it fails to reduce prolactin level, surgery should be considered. Objective: To analyze the clinical and radiological findings of prolactinoma and to assess the long-term outcome of its treatment options. Methods: This is a retrospective study of 35 patients with prolactinoma (9 males and 26 females, mean age 37±2.1 years). Data were collected through medical record review, imaging examination, and patient follow-up evaluation in neurosurgery and neurology departments, Suez Canal University Hospital, from 2001 to 2011. Results: The majority of the patients had macroadenoma (65.8%), with suprasellar extension in (40%), and some degree of cavernous invasion in (20%).  Macroadenoma was present in all males (100%), while microadenoma was frequent in females (46.2%) (P<0.01). Every patient had first a trial of medical treatment with dopamine agonist. Surgeries (Trans-sphenoidal or trans-cranial) were done for 19 patients (54.3%), while 16 patients (45.7%) were continued on medical treatment. The clinical (73.9%) and radiological (94.7%) recovery of patients after surgeries were better than those of patients on medical therapy (50.0%) and (37.5%) (P=0.3 and <0.05 respectively). Conclusion: Surgery especially Transsphenoidal is more effective than medical treatment for prolactinoma, especially in micro and macro non-invasive tumors. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(2): 135-141]

 Key Words: Bromocriptine, Cabergoline, Prolactinoma, Trans-sphenoidal surgeries

Correspondence to Ayman E. Galhom, Department of Neurosurgery, Suez Canal University, Egypt. E-mail: aiman2gm@hotmail.com

 





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