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KMID : 0942820090080020119
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Journal of Korean Brain Tumor Society
2009 Volume.8 No. 2 p.119 ~ p.125
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Results of Surgical Treatment of Prolactin-Secreting Pituitary Adenomas；Long Term Follow-Up Study
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Sung Kyung-Soo
Song Young-Jin
Kim Hyung-Dong
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Abstract
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Objective: It has been occasionally observed the hyperprolactinemia after the proper surgical treatment for the prolactinsecreting pituitary adenomas(prolactinomas) during the follow-up period. The purpose of this study is to evaluate the early postoperative hyperprolactinemia and the recurrence of the hyperprolactinemia, and to consider the treatment options in such cases.
Materials and Methods: We reviewed the data for 58 patients treated surgically by single surgeon and could be follow up for prolactinomas from January 1994 to December 2007. The data included the consecutive hormonal levels associated with the outcomes of treatment during follow-up period.
Results: Postoperative remission could be achieved in 33 of 58 patients(58.9%). There were 25 cases(41.1%) of early postoperative hyperprolactinemia. High preoperative prolactin level(?200 ng/mL) is the most reliable predictor of early postoperative hyperprolactinemia. Recurrence of hyperprolactinema occurred in 5 of the 33 patients with initial good controlled prolactin level and 10 of the 25 patients with early postoperative hyperprolactinemia. The early postoperative prolactin level in patients with the recurrent hyperprolactinemia were significantly higher than those of patients without recurrence. We applied the other treatments for the 25 patients with early postoperative hyperprolactinemia and 5 patients with recurrent hyperprolactinemia after the initial good controlled prolactin level during the follow-up period：the dopaminergic agonist(DA) in 20 cases；conventional radiotherapy and DA in 5 cases；radiosurgery and DA in 3 cases； reoperation, radiosurgery and DA in 2 cases. After applying theses treatment modalities, we achieved late postoperative prolactin levels of <25 ng/mL in 25 of the 30 cases.
Conclusion: The physicians should closely monitor the symptoms and serial hormonal levels for early detection of recurrent hyperprolactinemia during long term follow-up and keep these treatment options in mind for the management of hyperprolactinemia after the surgery.
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KEYWORD
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Recurrent hyperprolactinemia, Prolactinoma, Prolactin
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