title: Management of prolactinomas associated with very high serum prolactin levels.
abstract: The authors have reviewed the results of transsphenoidal microsurgical management in 69 patients with prolactin-secreting pituitary adenomas who had preoperative serum prolactin levels over 200 ng/ml. The patients were divided into three groups based on their preoperative serum prolactin levels: over 200 to 500 ng/ml (Group A); over 500 to 1000 ng/ml (Group B); and over 1000 ng/ml (Group C). The percentage of successful treatment ("control rate") was 68%, 30%, and 14%, respectively, in these three groups of patients. Based on these results, the authors offer guidelines for the management of patients with prolactin-secreting pituitary adenomas associated with exceptionally high serum prolactin levels. The surgical control rate of 68% in Group A seems to justify surgery for these patients, while primary medical care with bromocriptine is recommended for most patients with serum prolactin levels over 500 ng/ml.
authors.affiliation: Department of Surgery (Neurosurgery), Emory University School of Medicine, Atlanta, Georgia.
authors.forename: D L
authors.initials: DL
authors.lastname: Barrow
authors.forename: J
authors.initials: J
authors.lastname: Mizuno
authors.forename: G T
authors.initials: GT
authors.lastname: Tindall
mesh_terms: D000236:Adenoma / Q000097:blood / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000097:blood / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D001971:Bromocriptine; D011388:Prolactin