title: The safety of treatments for prolactinomas.
abstract: BACKGROUND
  Prolactinomas are the most common hormone-secreting pituitary tumors, accounting for approximately 40% of all pituitary tumors. Infertility, gonadal and sexual dysfunction are usually the most relevant clinical features in both sexes.
  
  
  METHODS
  This review focuses on safety and tolerability of therapeutic approaches for prolactinomas. Complications from trans-sphenoidal surgery vary depending on tumor size, and mortality rate ranges 0.6%-31% for patients with microprolactinomas and macroprolactinoms, respectively. More than 50% of patients receiving pituitary radiotherapy will develop at least one hormone deficiency within the following decade, whereas cerebrovascular accidents, second brain tumors and optic neuropathy rarely occur. Nowadays, treatment of prolactinomas is based on dopamine-agonists (DA), mainly cabergoline (CAB). Whether CAB is associated with an increased risk of clinically relevant cardiac valvulopathy in patients with prolactinomas as in those with Parkinson's disease (PD), is still debated. In most studies, CAB has been found not to be associated with an increased risk of significant valvulopathy in prolactinomas, and no correlation has been shown between valvular abnormalities and CAB duration or cumulative dose.
  
  
  CONCLUSIONS
  DA are safe and well tolerated, and the main safety concerns are related to the potential risk of clinically relevant valvulopathy following treatment with CAB, rarely occurring in patients with prolactinomas.
authors: a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University 'Federico II' , Naples , Italy.
authors: Renata S
authors: RS
authors: Auriemma
authors: a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University 'Federico II' , Naples , Italy.
authors: Ludovica F S
authors: LF
authors: Grasso
authors: a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University 'Federico II' , Naples , Italy.
authors: Rosario
authors: R
authors: Pivonello
authors: a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University 'Federico II' , Naples , Italy.
authors: Annamaria
authors: A
authors: Colao
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D010911:Pituitary Neoplasms / Q000188:drug therapy*; D015175:Prolactinoma / Q000188:drug therapy*; D012449:Safety
chemical_list: D000970:Antineoplastic Agents; D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline
keywords: Hyperprolactinemia; bromocriptine; cabergoline; cardiac valvulopathy; dopamine agonists; macroadenoma; microadenoma; pituitary tumor; radiotherapy; safety; surgery