title: Present status of neurosurgery in the treatment of prolactinomas.
abstract: Our experience with prolactinomas started in 1972 and is based on about 370 patients. Of these 247 were treated surgically, about 110 underwent medical therapy and a small number of patients were observed only. In microprolactinomas prolactin-levels could be normalized in up to 80% of the patients after selective adenomectomy. However, true recurrences were observed in 16% of the patients during long-term follow-up. The operative risk is rather low. There was no mortality in this series. The rate of complications is about 1%. Medical treatment with dopamine-agonists is successful especially in women who desire pregnancy, but should only be used in small microadenomas, in order to avoid complications. In larger macroprolactinomas h extra-sellar extension in whom primary surgical removal leads to a normalization of prolactin-levels in a minority of cases only primary therapy with dopamine-agonists leads to shrinkage of the tumour mass in about two-thirds of the patients. Since the tumour mass does not disappear completely after short-term medical treatment, we favour additional surgical tumour removal instead of long-lasting administration of dopamine-agonistic drugs in higher dosages.
authors.forename: R
authors.initials: R
authors.lastname: Fahlbusch
authors.forename: M
authors.initials: M
authors.lastname: Buchfelder
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D001971:Bromocriptine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D011182:Postoperative Care; D011247:Pregnancy; D011248:Pregnancy Complications; D011292:Premedication; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D013997:Time Factors
chemical_list: D000316:Adrenergic alpha-Agonists; D001971:Bromocriptine; D011388:Prolactin