No abstract available.
Prolactinoma*

No abstract available.
Prolactinoma*

No abstract available.
Hyperprolactinemia* ; Prolactinoma

No abstract available.
Prolactin* ; Prolactinoma* ; Radiosurgery*

Background and Objective: Prolactinoma is the most common functioning tumor of the pituitary gland. While its clinical course and outcomes among different populations have been vastly described in the past, data of prolactinoma among Filipinos has not been explored. This paper aims to describe the clinical profile and outcome of prolactinoma among adult Filipino patients. Methods: We conducted a retrospective cohort study including 41 patients with prolactinoma seen at the Philippine General Hospital. The clinical profile, cranial imaging features, treatment modalities given, and their outcomes over a mean follow up of 16 months were evaluated. Results: The mean age at diagnosis was 36.76 ±13.99 years. Majority of our cohort were females. Macroprolactinoma were found in 75.61% and giant prolactinoma in 9.76%. The remaining 12.2% were mixed GH and PRL secreting tumors. Most common symptoms at presentation were blurring of vision, headache, and amenorrhea. Median PRL levels was 353 (200-470) ng/ml. Medical therapy with Bromocriptine was the primary treatment modality used in 78% of patients. We found no significant difference between patients who underwent surgical and medical primary treatment modalities in terms of outcomes. At the end of follow up, 82.6 % of patients achieved at least more than 50% reduction in their prolactin levels. Conclusion Overall, our study showed that adult Filipino patients with prolactinoma have a larger tumor size at diagnosis and a lower rate of improvement of gonadal function after treatment. There were no statistically significant differences in clinical and biochemical outcomes between the treatment modalities used.
Prolactinoma ; Pituitary Neoplasms ; Prolactin

Over the past 10 years, considerable advances have been made in the surgical treatment of pituitary adenomas, with a high incidence of complete tumor removal reported. Increasing use of surgical magnification for surgery of the sellar region has created a need for more detailed surgical anatomical studies of this area and for special attention to the anatomical variants important to the transfrontal and transsphenoidal surgical approaches. The author discussed the surgical problems conderning hypersecretory pituitary adenomas. Here, there is a triple objective:treatment of the tumor, treatment of the hyperhormonism and the prevention of postoperative recurrences and complications. In this paper, an attempt has been made to correlate a surgical management of pituitary tumor characteristics with 1) microsurgical anatomy of the sella region; 2) surgical approaches and indication; 3) surgical complications; 4) comparison of therapentic options between surgical and medical treatment; 5) pituitary adenoma and pregnancy; 6) management of recurrent hyperfunctional pituitary adenomas; 7) pre-and postoperative radiation therapeutic effects.
Acromegaly ; Incidence ; Pituitary Neoplasms* ; Pregnancy ; Prolactinoma ; Recurrence

seconds ; defects ; Visual Fields ; Prolactinoma ; Bromocriptine

BACKGROUND: Cabergoline is typically effective for treating prolactinomas; however, some patients display cabergoline resistance, and the early characteristics of these patients remain unclear. We analyzed early indicators predicting long-term response to cabergoline. METHODS: We retrospectively reviewed the cases of 44 patients with macroprolactinomas who received cabergoline as first-line treatment; the patients were followed for a median of 16 months. The influence of various clinical parameters on outcomes was evaluated. RESULTS: Forty patients (90.9%) were treated medically and displayed tumor volume reduction (TVR) of 74.7%, a prolactin normalization (NP) rate of 81.8%, and a complete response (CR; TVR >50% with NP, without surgery) rate of 70.5%. Most patients (93.1%) with TVR > or =25% and NP at 3 months eventually achieved CR, whereas only 50% of patients with TVR > or =25% without NP and no patients with TVR <25% achieved CR. TVR at 3 months was strongly correlated with final TVR (R=0.785). Patients with large macroadenomas exhibited a low NP rate at 3 months, but eventually achieved TVR and NP rates similar to those of patients with smaller tumors. Surgery independently reduced the final dose of cabergoline (beta=-1.181 mg/week), and two of four patients who underwent surgery were able to discontinue cabergoline. CONCLUSION: Determining cabergoline response using TVR and NP 3 months after treatment is useful for predicting later outcomes. However, further cabergoline administration should be considered for patients with TVR >25% at 3 months without NP, particularly those with huge prolactinomas, because a delayed response may be achieved. As surgery can reduce the cabergoline dose necessary for successful disease control, it should be considered for cabergoline-resistant patients.
Dopamine ; Humans ; Hyperprolactinemia ; Prolactin ; Prolactinoma* ; Retrospective Studies ; Tumor Burden

OBJECTIVE: This study is designed to demonstrate the factors influencing on the the postoperative remission or recurrence after transsphenoidal approach(TSA) for treatment of the prolactinomas. METHODS:This study included 18 patients who underwent TSA. Pre- and post-operative magnetic resonance(MR) image, and serum prolactin levels were checked. Classification(Grade I-V, Stage 0-E) of the tumor were performed based on the preoperative MR image and intraoperative surgical finidngs. "Remission" was defined when normal serum prolactin level without amenorrhea, galactorrhea was noticed. "Recurrence" was defined when postoperative prolactin level was above 20ng/ml and amennorrhea, galactorrhea were presented. RESULTS: Patients were grade I in eight, grade II in six, grade III in three, and grade IV in one. Postoperative results showed remission in 13 and recurrence in five. Depending on preoperative serum prolactin levels, remission was achieved in 100% of patients under 100ng/ml, 83% of patients in 100-200ng/ml, and 50% of patients above 200ng/ml. Remission was noticed in 75.0% of grade I, 83.3% of grade II, 66.6% of grade III, and 0% of grade IV. Also, remission was presented in 80.0% of stage 0, 66.7% of stage A, 0% of Stage B. CONCLUSION: After TSA, remission could be achieved in patients with low preoperative serum prolactin level, small sized tumor, and less invasive tumor into the sellar floor. It is suggested that preoperative serum prolactin level, tumor size, and invasiveness of the tumor into the sellar floor are of value in prediction of the remission after TSA in patients with prolactinoma.
Amenorrhea ; Female ; Galactorrhea ; Humans ; Pregnancy ; Prolactin ; Prolactinoma* ; Recurrence

The authors have reported on 34 patients with pituitary adenoma who underwent surgical treatment. The preoperative and postoperative clinical manifestations, size, and extension of tumor, therapeutic modalities and changes of endocrinological symptoms and hormonal values. In a series of 34 adenomas, 7(25%) were non-secreting and 27(79%) produced a hypersecretion syndrome; human growth hormone(5), prolactin(17), mixed GH and PRL type(3), corticotropic adenoma(2). The principal symptoms were endocrinological symptoms(74%), visual disturbance(59%) and headache(50%) on a admission. Vision improved in 90% of the patients. Normal menstruation returned in 35.3% of the prolactinoma. Endocrine cure was possible in 24% of prolactin-secreting and 40% of GH-secreting and 33% of mixed GH, PRL adenomas and not improved in corticotropic adenomas. The mortality rate was 0.6%. Postoperative radiation therapy appeared to play a greater role.
Adenoma ; Craniotomy ; Female ; Humans ; Menstruation ; Mortality ; Pituitary Neoplasms* ; Prolactinoma