Healthcare: Neurosurgery



Prolactinoma is a benign tumor of the pituitary gland that produces the hormone prolactin. The tumor is usually treated medically with dopamine agonists (bromocriptine, cabergoline).

Normally, prolactin secretion from the pituitary gland is inhibited by dopamine, so it is rational that a medication that binds to the dopamine receptor on the surface of these tumors also would prevent prolactin secretion. Importantly, many prolactinomas respond very well to these oral medications and patients have normalization of prolactin levels, and importantly, shrinkage of the tumor even to where it can even disappear on imaging.

Some patients are considered to be in remission with disappearance of their adenoma. The role of surgery in treating prolactinoma is primarily as a second line behind medical therapy, in particular for tumors that are resistant to medication or for patients who cannot tolerate side effects from the medications. However, modern endoscopic pituitary surgery is very effective in curing prolactinomas and is worthy of consideration in patients who do not want to take medications.