PROLACTIN-SECRETING ADENOMAS - SURGICAL R ESULTS

A retrospective study of 75 patients operated for pituitary prolactin- secreting adenomas between 1972 and 1992 is presented. 57 were women, 18 males. The major symptom was amenorrhea for women and impotence for men. Prolactinemia is correlated to the size of adenoma and thus perm its a prediction of surgical results. Most of the patients with a prol actinemia under 300 ng/ml were cured by surgery alone. Surgical treatm ent alone at the-term follow-up cure 87 % of the micro-adenomas, 17 % of the enclosed adenomas, and none of the invasive adenomas. In this s tudy there is only 7 % of true recurrence. According to the high cure rate and low frequency recurrence after transphenoidal surgery for mic ro-adenomas we suggest this approach as the first choice treatment. On the other hand the best treatment for macro-prolactinomas is medicame ntous.