The results of surgical treatment on prolactinomas in females of child bearing ages
S Fujio, M Habu, S Yunoue, H Hirano & K Arita
Introduction: Medical therapy with dopaminergic drugs is the preferred initial treatment for symptomatic prolactinoma. However, some drawbacks of medical therapy are still of concern. Surgery is indicated in cases of resistance or intolerance to drugs or where patients prefer definitive cure to lifelong drug treatment. In addition, young women with small and enclosed type tumor may be good candidates for surgical treatment because of high curability and safety. We evaluated the long-term effect of surgery in patients who had been followed up longer than 1 year postoperatively.
Methods: Subjects are 16 females of child bearing ages who underwent transsphenoidal resection of prolactinomas from 2006 through 2010.
Results: Mean age at surgery was 25.8±6.2 years. Preoperatively, 37.5% patients had received medical treatment. Mean preoperative PRL concentration was 224.2±138.4 ng/ml. Mean tumor diameter was 12.1±6.0 mm. At the time of diagnosis, 81.3% patients had amenorrhea, and 18.7% patients had oligomenorrhea. Mean postoperative PRL concentration was 6.2±4.5 ng/ml. Surgical cure was achieved in all patients, and they had regular menstruation. No operative severe morbidity occurred. Gonadotropin secretory function was also well preserved. At the latest follow-up, 42.9±17.4 months after surgery, four patients have given birth, but a patient whose PRL level increased again has received cabergoline therapy.
Conclusion: The surgical treatment by skillful hands on small and enclosed prolactinomas in young females is still one of reasonable choices for its safety and efficacy.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.