Clinical features and medical treatment of male prolactinomas

Background. Prolactinomas found in male patients show distinct clinical fea tures compared to those in female patients, which may warrant a different t reatment strategy. Method. To clarify their clinical features and to evaluate the treatment re sults. specifically the results of surgical treatment and non-surgical trea tment solely with oral bromocriptine, we retrospectively reviewed our exper ience in male prolactinoma cases. Findings. From 1988 to 1998, we had 184 pituitary adenoma patients, and thi rteen of those were male patients with a pure prolactinoma, Of the thirteen patients, eight underwent transsphenoidal surgery followed by oral bromocr iptine (surgical group), and five were treated solely with bromocriptine or terguride (non-surgical group). In both groups, the visual symptoms and si gns resolved after the treatment, and the serum prolactin levels were norma lised with minimal maintenance dose of bromocriptine. Notably. improvement of the visual symptom in the three non-surgically treated patients was obse rved within a week following the bromocriptine administration. Interpretation. Although surgery would continue to play an important parr o f treatment in some cases with a large tumour. our experience suggests that drug treatment without surgery can be a safe and effective option in the m anagement of male prolactinoma patients.