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August 17, 1984, Vol 252, No. 7 >
ARTICLE | August 17, 1984

Long-term Follow-up of Transsphenoidal Selective Adenomectomy for Prolactinoma FREE

Elise F. Rodman, MD; Mark E. Molitch, MD; Kalmon D. Post, MD; Bruce J. Biller, MD; Seymour Reichlin, MD, PhD
[+] Author Affiliations

Read in part before the annual meeting of the American Academy of Neurological Surgeons, Pebble Beach, Calif, Oct 25, 1983.

Reprint requests to Center for Endocrinology, Metabolism, and Nutrition, Northwestern University Medical School, 303 E Chicago Ave, Chicago, IL 60611 (Dr Molitch).


JAMA. 1984;252(7):921-924. doi:10.1001/jama.1984.03350070039020
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References

Although transsphenoidal selective resection of prolactinoma has high cure rates and low morbidity, the frequency of late recurrence of adenoma is controversial. Long-term follow-up data were available on 29 of our patients having initial return to normal prolactin levels after microadenoma resection; in 24, prolactin levels remained normal at 50 ± months' (range, 11 to 81 months) follow-up. Five patients manifested hyperprolactinemia again after intervals of six to 16 months. In five patients with normal prolactin levels immediately after macroadenoma resection, who were available for long-term follow-up, prolactin levels remained normal in four at 41 ±3 months; one patient had a relapse 78 months after surgery. Testing of prolactin secretory dynamics six weeks postoperatively was not predictive of who would suffer relapse. It is not known whether these relapses are due to regrowth of tumor remnants or represent new tumor formation.

(JAMA 1984;252:921-924)

REFERENCES

1 +
Reichlin S, Molitch ME:  Neuroendocrine aspects of pituitary adenomas , in Camanni F, Muller EE (eds): Pituitary Hyperfunction: Pathophysiology and Clinical Aspects . New York, Raven Press, 1984;, pp 47-70.
2 +
Serri O, Rasio E, Beauregard H, et al:  Recurrence of hyperprolactinoma after selective transsphenoidal adenomectomy in women with prolactinoma . N Engl J Med 1983;;309:280-283.
3 +
Jaquet P, Guibout M, Lucioni J, et al:  Hypothalamopituitary regulation of prolactin in hypersecreting prolactinoma , in Robyn C, Harter M (eds): Progress in Prolactin, Physiology and Pathology . New York, Elsevier North Holland Inc, 1978;, pp 371-382.
4 +
Tucker HSG, Grubb SR, Wigand JP, et al:  Galactorrhea-amenorrhea syndrome: Follow-up of 45 patients after pituitary tumor removal . Ann Intern Med 1982;;94:302-307.
5 +
Giovanelli M, Gaini SM, Tomei G, et al:  Follow-up review of microprolactinomas operated in 48 female patients . Excerpta Med Int Congr Ser 1982;;584:189-196.
6 +
Von Werder K, Eversmann T, Fahlbusch R, et al:  Development of hyperprolactinemia in patients with adenomas with and without prior operative treatment . Excerpta Med Int Congr Ser 1982;;584:175-188.
7 +
Camanni F, Ghigo E, Ciccarelli E, et al:  Follow-up of 69 patients after pituitary tumor removal for hyperprolactinemia . Excerpta Med Int Congr Ser 1982;;584:205-213.
8 +
Nencioni T, Miragoli A, Bertaglia MG, et al:  Medical and surgical treatment of microprolactinomas: Long-term follow-up . Excerpta Med Int Congr Ser 1982;;584:215-218.
9 +
Faria MAJ, Tindall GT:  Transsphenoidal microsurgery for prolactin-secreting pituitary adenomas . J Neurosurg 1982;;56:33-43.
10 +
Barbarino A, De Marinis L, Anile C, et al:  Dopaminergic mechanisms regulating prolactin secretion in patients with prolactin-secreting pituitary adenoma: Long-term studies after selective transsphenoidal surgery . Metabolism 1982;;31:1100-1104.
11 +
Post KD, Biller BJ, Adelman LS, et al:  Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea . JAMA 1979;;242:158-162.
12 +
Molitch ME, Goodman RH, Post KD, et al:  Surgical cure of prolactinoma reverses abnormal prolactin response to carbidopa/L-dopa . J Clin Endocrinol Metabol 1982;;55:1118-1123.
13 +
Molitch ME, Reichlin S:  Neuroendocrine studies of prolactin secretion in hyperprolactinemic states , in Mena F, Valverole-Rodriguez C (eds): Frontiers and Perspectives in Prolactin Secretion: A Multidisciplinary Approach . New York, Academic Press, in press.
14 +
Tucker HSG, Lankford HV, Blackard WG:  Persistent defect in regulation of prolactin secretion following successful pituitary tumor removal in women with galactorrhea-amenorrhea syndrome . J Clin Endocrinol Metabol 1980;; 51:968-977.
15 +
Schlechte JA, Sherman BM:  Abnormal regulation of prolactin secretion after successful surgery for prolactin-secreting pituitary tumors . Clin Endocrinol 1981;;15:165-174.
16 +
Woolf PD, Lee LA, Leebaw WF:  Hypoglycemia as a provocative test of prolactin release . Metabolism 1978;;27:869-877.
17 +
Hwang P, Guyda H, Friesen H:  A radioimmunoassay for human prolactin . Proc Nati Acad Sci USA 1971;;68:1902-1906.
18 +
Sinha YN, Selby FW, Lewis UJ, et al:  A homologous radioimmunoassay for human prolactin . J Clin Endocrinol Metabol 1973;;36:509-516.
19 +
Samaan NA, Elhaj GE, Leavens ME, et al:  The clinical and biochemical features in 26 patients with prolactinoma before and after transsphenoidal microresection . Acta Endocrinol 1980;;94:450-458.

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1 +
Reichlin S, Molitch ME:  Neuroendocrine aspects of pituitary adenomas , in Camanni F, Muller EE (eds): Pituitary Hyperfunction: Pathophysiology and Clinical Aspects . New York, Raven Press, 1984;, pp 47-70.
2 +
Serri O, Rasio E, Beauregard H, et al:  Recurrence of hyperprolactinoma after selective transsphenoidal adenomectomy in women with prolactinoma . N Engl J Med 1983;;309:280-283.
3 +
Jaquet P, Guibout M, Lucioni J, et al:  Hypothalamopituitary regulation of prolactin in hypersecreting prolactinoma , in Robyn C, Harter M (eds): Progress in Prolactin, Physiology and Pathology . New York, Elsevier North Holland Inc, 1978;, pp 371-382.
4 +
Tucker HSG, Grubb SR, Wigand JP, et al:  Galactorrhea-amenorrhea syndrome: Follow-up of 45 patients after pituitary tumor removal . Ann Intern Med 1982;;94:302-307.
5 +
Giovanelli M, Gaini SM, Tomei G, et al:  Follow-up review of microprolactinomas operated in 48 female patients . Excerpta Med Int Congr Ser 1982;;584:189-196.
6 +
Von Werder K, Eversmann T, Fahlbusch R, et al:  Development of hyperprolactinemia in patients with adenomas with and without prior operative treatment . Excerpta Med Int Congr Ser 1982;;584:175-188.
7 +
Camanni F, Ghigo E, Ciccarelli E, et al:  Follow-up of 69 patients after pituitary tumor removal for hyperprolactinemia . Excerpta Med Int Congr Ser 1982;;584:205-213.
8 +
Nencioni T, Miragoli A, Bertaglia MG, et al:  Medical and surgical treatment of microprolactinomas: Long-term follow-up . Excerpta Med Int Congr Ser 1982;;584:215-218.
9 +
Faria MAJ, Tindall GT:  Transsphenoidal microsurgery for prolactin-secreting pituitary adenomas . J Neurosurg 1982;;56:33-43.
10 +
Barbarino A, De Marinis L, Anile C, et al:  Dopaminergic mechanisms regulating prolactin secretion in patients with prolactin-secreting pituitary adenoma: Long-term studies after selective transsphenoidal surgery . Metabolism 1982;;31:1100-1104.
11 +
Post KD, Biller BJ, Adelman LS, et al:  Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea . JAMA 1979;;242:158-162.
12 +
Molitch ME, Goodman RH, Post KD, et al:  Surgical cure of prolactinoma reverses abnormal prolactin response to carbidopa/L-dopa . J Clin Endocrinol Metabol 1982;;55:1118-1123.
13 +
Molitch ME, Reichlin S:  Neuroendocrine studies of prolactin secretion in hyperprolactinemic states , in Mena F, Valverole-Rodriguez C (eds): Frontiers and Perspectives in Prolactin Secretion: A Multidisciplinary Approach . New York, Academic Press, in press.
14 +
Tucker HSG, Lankford HV, Blackard WG:  Persistent defect in regulation of prolactin secretion following successful pituitary tumor removal in women with galactorrhea-amenorrhea syndrome . J Clin Endocrinol Metabol 1980;; 51:968-977.
15 +
Schlechte JA, Sherman BM:  Abnormal regulation of prolactin secretion after successful surgery for prolactin-secreting pituitary tumors . Clin Endocrinol 1981;;15:165-174.
16 +
Woolf PD, Lee LA, Leebaw WF:  Hypoglycemia as a provocative test of prolactin release . Metabolism 1978;;27:869-877.
17 +
Hwang P, Guyda H, Friesen H:  A radioimmunoassay for human prolactin . Proc Nati Acad Sci USA 1971;;68:1902-1906.
18 +
Sinha YN, Selby FW, Lewis UJ, et al:  A homologous radioimmunoassay for human prolactin . J Clin Endocrinol Metabol 1973;;36:509-516.
19 +
Samaan NA, Elhaj GE, Leavens ME, et al:  The clinical and biochemical features in 26 patients with prolactinoma before and after transsphenoidal microresection . Acta Endocrinol 1980;;94:450-458.

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