Erevaluation of pituitary adenomectomy as a method of treatment in prolactinomas
Issue: 1/1998
Author: M. Andreeva, Ph. Kumanov, A. Tomova, M. Orbetzova, S. Dimitrov1 , Clinical Centre of Endocrinology and Gerontology, Medical University, Sofia 1 Clinic of Neurosurgery, State University Hospital „St. Anne", Sofia
Abstract:
The study comprises 133 patients with established prolactinoma/122 females, aged 15-53 years (mean age 30,1 ± 0,66 years) and 11 males, aged 20-62 years (mean age 35,82 ± 11,75 years). All of them have been treated surgically from year 1978 to 1995. The patients were studied preoperatively as well as between the third and sixth months and on the first year after surgery.
The mean preoperative prolactin level in the females was 4083,5 ± 498,2 mlU/L. It decreased significantly to 1972,8 ± 498,2 mlU/L (P < 0,001) between the third and sixth postoperative months and showed slight tendency to increase (up to 2348,0 ± 183,16 mlU/L) at the end of the first postoperative year, remaining significantly lower (P < 0,001) as compared to the initial level. A complete clinical and hormonal remission was achieved in 32 (26,2%) of the females between the third and sixth postoperative months. The normoprolactinaemia persisted in only 20 patients (16,4%) until the end of the first year.
Preceeding polycystic ovary syndrome was found in 18 females (14,8%). In 57 females (46,7%) prolactinomas developed after pregnancy and/or labour and in the rest it was discovered in the view of primary sterility.
Circulating prolactin concentrations in males were very high prior to treatment, ranging from 1755 to 17200 mlU/L, mean value7797,8 ± 1617,97 mlU/L.
Our data confirm that dopamine antagonists could not replace definitly neurosurgical treatment of prolactionomas. Pituitary adenomectomy keeps its certain place as a method of choice.
Keywords: prolactin, prolactinoma, pituitary adenomectomy.
