FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 309:280-283 August 4, 1983 Number 5 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

To assess the long-term prognosis for women with prolactinoma after selective transsphenoidal adenomectomy, we followed 44 patients for 6.2 +/- 1.5 years. Group 1 (28 patients) had microprolactinomas, and Group 2 (16 patients) had macroprolactinomas. After surgery, normal plasma prolactin levels, resumption of menses, and cessation of galactorrhea were observed in 24 Group 1 patients (85 per cent) and 5 Group 2 patients (31 per cent). Hyperprolactinemia recurred in 12 of the 24 Group 1 patients and in 4 of the 5 Group 2 patients after 4 +/- 1.3 and 2.5 +/- 1.6 years of remission, respectively. There was no radiologic evidence of tumor recurrence in any patient, and no relation was found between the occurrence of pregnancy after surgery and the recurrence of hyperprolactinemia. Clinical and biologic features before surgery could not predict the long-term outcome. However, the immediate postoperative level of plasma prolactin was significantly lower in patients in whom normal prolactinemia (6.4 +/- 1.1 ng per milliliter) was maintained than in those who relapsed (11.7 +/- 1.5 ng per milliliter) (P less than 0.02). We conclude that recurrence of hyperprolactinemia after successful surgery is frequent but delayed. The immediate postoperative level of plasma prolactin may be a predictive risk factor.

This article has been cited by other articles:

• Kreutzer, J, Buslei, R, Wallaschofski, H, Hofmann, B, Nimsky, C, Fahlbusch, R, Buchfelder, M (2008). Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients. Eur J Endocrinol 158: 11-18 [Abstract] [Full Text]  
• Gillam, M. P., Molitch, M. E., Lombardi, G., Colao, A. (2006). Advances in the Treatment of Prolactinomas. Endocr. Rev. 27: 485-534 [Abstract] [Full Text]  
• Schlechte, J. A. (2003). Prolactinoma. NEJM 349: 2035-2041 [Full Text]  
• Serri, O., Chik, C. L., Ur, E., Ezzat, S. (2003). Diagnosis and management of hyperprolactinemia. CMAJ 169: 575-581 [Abstract] [Full Text]  
• Losa, M., Mortini, P., Barzaghi, R., Gioia, L., Giovanelli, M. (2002). Surgical Treatment of Prolactin-Secreting Pituitary Adenomas: Early Results and Long-Term Outcome. J. Clin. Endocrinol. Metab. 87: 3180-3186 [Abstract] [Full Text]  
• Freda, P. U., Wardlaw, S. L. (1999). Diagnosis and Treatment of Pituitary Tumors. J. Clin. Endocrinol. Metab. 84: 3859-3866 [Full Text]  
• Thomson, J. A, Davies, D. L, McLaren, E. H, Teasdale, G. M (1994). Ten year follow up of microprolactinoma treated by transsphenoidal surgery. BMJ 309: 1409-1410 [Full Text]  
• Serri, O. (1994). Progress in the Management of Hyperprolactinemia. NEJM 331: 942-944 [Full Text]  
• Serri, O., Hardy, J., Massoud, F. (1993). Relapse of Hyperprolactinemia Revisited. NEJM 329: 1357-1357 [Full Text]