English (United Kingdom)Español (spanish formal Internacional)

MC Facebook


Home Criteria Endocrinology and Metabolism Indications for Therapy and for Neurosurgery in Patients with Prolactinomas


The content of this website is provided for general informational purposes only and is not a substitute professional medical advice

Indications for Therapy and for Neurosurgery in Patients with Prolactinomas Print E-mail
User Rating: / 1
Written by G. Firman MD   
Thursday, 08 April 2010 03:52


In contrast to macroadenomas, for which therapy is routinely indicated, microadenomas do not always require treatment. For patients with microadenomas who do not have these indications, symptoms and prolactin levels can be monitored, and MRI can be used to follow the size of the tumor.

Indications for Therapy in Patients with Prolactinomas

  • Macroadenoma
  • Enlarging microadenoma
  • Infertility
  • Bothersome galactorrhea
  • Gynecomastia
  • Testosterone deficiency
  • Oligomenorrhea or amenorrhea
  • Acne and hirsutism


Given the efficacy of medical therapy, only a small minority of patients with prolactinomas require transsphenoidal surgery or radiation therapy. Surgical cure rates, which are highly dependent on surgical skill and tumor anatomy, approach 80 to 90% for microadenomas but are less than 50% for macroadenomas.

Indications for Neurosurgery in Patients with Prolactinomas

  • Increasing tumor size despite optimal medical therapy
  • Pituitary apoplexy
  • Inability to tolerate dopamine agonist therapy
  • Dopamine agonist–resistant macroadenoma
  • Dopamine agonist–resistant microadenoma in a woman seeking fertility, if ovulation induction is not appropriate
  • Persistent chiasmal compression despite optimal medical therapy
  • Medically unresponsive cystic prolactinoma
  • In women seeking fertility, macroadenoma in close proximity to optic chiasm despite optimal medical therapy (prepregnancy debulking recommended)
  • Cerebrospinal fluid leak during administration of dopamine agonist
  • Macroadenoma in a patient with a psychiatric condition for which dopamine agonists are contraindicated




  1. Klibanski A. Clinical practice. Prolactinomas. N Engl J Med. 2010 Apr 1;362(13):1219-26. [Medline]
  2. Molitch ME. Medical management of prolactin-secreting pituitary adenomas. Pituitary. 2002;5(2):55-65.[Medline]



Created: Abr 08, 2010.



Related news items:
Newer news items:
Older news items:

Last Updated on Friday, 29 August 2014 04:06

Free Registry



HONcode accreditation seal. We comply with the HONcode standard for health trust worthy information:
verify here

Site Last Modified

Wednesday 17 January 2018, 14:29


Copyright © 2005-2018. All Rights Reserved