Clinical features and medical treatment of male prolactinomas.
BACKGROUND
Prolactinomas found in male patients show distinct clinical features compared to those in female patients, which may warrant a different treatment strategy.


METHODS
To clarify their clinical features and to evaluate the treatment results, specifically the results of surgical treatment and non-surgical treatment solely with oral bromocriptine, we retrospectively reviewed our experience in male prolactinoma cases.


RESULTS
From 1988 to 1998, we had 184 pituitary adenoma patients, and thirteen of those were male patients with a pure prolactinoma. Of the thirteen patients, eight underwent transsphenoidal surgery followed by oral bromocriptine (surgical group), and five were treated solely with bromocriptine or terguride (non-surgical group). In both groups, the visual symptoms and signs resolved after the treatment, and the serum prolactin levels were normalised with minimal maintenance dose of bromocriptine. Notably, improvement of the visual symptom in the three non-surgically treated patients was observed within a week following the bromocriptine administration.


CONCLUSIONS
Although surgery would continue to play an important part of treatment in some cases with a large tumour, our experience suggests that drug treatment without surgery can be a safe and effective option in the management of male prolactinoma patients.
Asano
S
S
Department of Neurosurgery, The University of Tokyo Hospital, Japan.
Ueki
K
K
Suzuki
I
I
Kirino
T
T
D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use*; D019299:Decompression, Surgical; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007989:Libido / Q000187:drug effects; D008090:Lisuride / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D015175:Prolactinoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014794:Visual Fields / Q000187:drug effects
D018491:Dopamine Agonists; D006727:Hormone Antagonists; C006208:dironyl; D001971:Bromocriptine; D008090:Lisuride