Open AccessGiant Prolactinomas
Author(s) -
Ilan Shimon
Publication year - 2018
Publication title -
neuroendocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.493
H-Index - 101
eISSN - 1423-0194
pISSN - 0028-3835
DOI - 10.1159/000495184
Subject(s) - cabergoline , prolactinoma , bromocriptine , medicine , optic chiasm , prolactin , pituitary gland , pituitary neoplasm , adenoma , pituitary adenoma , endocrinology , ophthalmology , hormone , optic nerve
Prolactin-secreting adenomas (prolactinomas) are the most common secreting adenomas of the pituitary. Microprolactinomas (diameter 40 mm, are rare, accounting for only 1–5% of all prolactinomas. Although generally benign, giant prolactinomas are aggressive and invasive, extending into the suprasellar region and also involving the cavernous sinuses. The optic chiasm is frequently involved, which leads to visual damage, and patients occasionally suffer from ophthalmoplegia. Long-term (usually lifetime) therapy with high-dose dopamine agonists (cabergoline or bromocriptine), together with pituitary surgery in some cases and radiotherapy if required, can achieve biochemical remission, tumor control, and clinical improvement in most patients.