THE PLACE OF SURGERY IN THE MANAGEMENT OF PROLACTIN SECRETING ADENOMAS.

Autor: Rotariu DI; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'N. Oblu' Clinical Emergency Hospital, Department of Neurosurgery., Costachescu B; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'N. Oblu' Clinical Emergency Hospital, Department of Neurosurgery., Ungureanu MC; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'St. Spyridon' County Clinical Emergency Hospital, Department of Endocrinology, Iasi, Romania., Eva L; 'N. Oblu' Clinical Emergency Hospital, Department of Neurosurgery., Leustean L; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'St. Spyridon' County Clinical Emergency Hospital, Department of Endocrinology, Iasi, Romania., Preda C; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'St. Spyridon' County Clinical Emergency Hospital, Department of Endocrinology, Iasi, Romania., Cristea C; 'St. Spyridon' County Clinical Emergency Hospital, Department of Endocrinology, Iasi, Romania., Iliescu BF; 'Gr. T. Popa' University of Medicine and Pharmacy.; 'N. Oblu' Clinical Emergency Hospital, Department of Neurosurgery.
Jazyk: angličtina
Zdroj: Acta endocrinologica (Bucharest, Romania : 2005) [Acta Endocrinol (Buchar)] 2024 Jan-Mar; Vol. 20 (1), pp. 65-73. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.4183/aeb.2024.65
Abstrakt: 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.
Competing Interests: The authors declare that they have no conflict of interest.
(©2024 Acta Endocrinologica (Buc).)
Databáze: MEDLINE
Externí odkaz: