Department of Neurosurgery, Brigham and Women's Hospital, BTM 4, 60 Fenwood Road, Boston, MA 02115, USA.
Department of Neurosurgery, Brigham and Women's Hospital, BTM 4, 60 Fenwood Road, Boston, MA 02115, USA.
Neurosurg Clin N Am. 2019 Oct;30(4):509-514. doi: 10.1016/j.nec.2019.05.010. Epub 2019 Jul 2.
Prolactinomas are the most common functional pituitary adenoma. Many prolactinomas can be treated with medication, but all patients should be evaluated at a neuroendocrine center including experienced neurosurgeons trained in transsphenoidal surgery. Surgery for prolactinomas is feasible and can be performed with low morbidity. Patients never previously treated with dopamine agonists should be considered for surgery if they have neurologic deficits, pituitary apoplexy, an uncertain diagnosis, or a significantly cystic prolactinoma. Patients previously treated with dopamine agonists should be considered for surgery in cases of intolerance or resistance. Recurrent and aggressive prolactinomas often require multimodal therapy.
催乳素瘤是最常见的功能性垂体腺瘤。许多催乳素瘤可以通过药物治疗，但所有患者都应在神经内分泌中心进行评估，包括接受过经蝶窦手术培训的经验丰富的神经外科医生。催乳素瘤的手术是可行的，并且可以以低发病率进行。如果患者有神经功能缺损、垂体卒中、不确定的诊断或明显囊性催乳素瘤，则从未接受过多巴胺激动剂治疗的患者应考虑手术。如果患者不耐受或耐药，则应考虑手术治疗。复发性和侵袭性催乳素瘤通常需要多模式治疗。
