Maiter Dominique
Head, Division of Endocrinology; Professor of Medicine, Department of Endocrinology and Nutrition Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Eur Endocrinol. 2015 Apr;11(1):39-40. doi: 10.17925/EE.2015.11.01.39. Epub 2015 Apr 11.
Although the diagnosis of prolactinoma is often straightforward and the treatment strategy has been well defined in recent guidelines, several challenging issues persist in their management. The differential diagnosis of a large pituitary tumour with moderately elevated prolactin (PRL) concentrations is sometimes difficult, and prolonged treatment with a dopamine agonist may be inappropriate when the diagnosis of a prolactinoma is not sufficiently well substantiated. Also, timely withdrawal of dopamine agonist treatment and the remaining indications of transsphenoidal surgery are still matters of debate. Last but not least, the management of resistant or aggressive prolactinomas remains a challenge for the clinician, especially when they occur in young patients.
尽管泌乳素瘤的诊断通常较为直接，且近期指南已明确了治疗策略，但在其管理方面仍存在一些具有挑战性的问题。对于泌乳素（PRL）浓度中度升高的大型垂体肿瘤，鉴别诊断有时较为困难，而且当泌乳素瘤的诊断依据不充分时，长期使用多巴胺激动剂治疗可能并不合适。此外，多巴胺激动剂治疗的适时停药以及经蝶窦手术的其余指征仍是有争议的问题。最后但同样重要的是，难治性或侵袭性泌乳素瘤的管理对临床医生而言仍是一项挑战，尤其是当这些肿瘤发生在年轻患者身上时。
