{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:38:28Z","timestamp":1740166708232,"version":"3.37.3"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"S 02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Initial therapy for the management of prolactinomas has long been maintained to be medical, consisting of a dopamine agonist. These therapies may have troublesome side effects, and some prolactinomas are resistant to medical therapy regarding lowering prolactin levels or shrinking the tumor. These issues have revived interest in surgery for prolactin-secreting adenomas as an early therapeutic option. We report our analysis of surgery for prolactin microadenomas in women, using the transsphenoidal endoscopic approach.<\/jats:p><jats:p>\n          Design\u2003We reviewed a contemporary series of 33 women (mean age\u2009=\u200931.8 years) with microprolactinomas who underwent early surgical intervention, which was a three-dimensional transnasal transsphenoidal endoscopic operation.<\/jats:p><jats:p>\n          Setting\u2003The study was conducted at a tertiary academic referral center for pituitary tumors.<\/jats:p><jats:p>\n          Main Outcome Measures\u2003Preoperative and postoperative prolactin.<\/jats:p><jats:p>\n          Results\u2003Overall, 28 patients had received preoperative dopamine agonists, 24 of these experienced a variety of drug-related side effects, and 4 had tumors that were resistant to lowering prolactin or tumor shrinkage. Preoperative prolactin levels averaged 90.3 ng\/mL (range\u2009=\u200930.7\u2013175.8 ng\/mL). We observed a 94% normalization rate in postoperative prolactin (mean\u2009=\u200910.08 ng\/mL, range\u2009=\u20090.3\u201363.1 ng\/mL). During the follow-up (mean\u2009=\u200933.9 months), five patients had elevated prolactin; four required reinitiation of medical therapy, two had surgical reexploration, and none received radiation therapy. Complications included syndrome of inappropriate antidiuretic hormone secretion (n\u2009=\u20093), transient diabetes insipidus (n\u2009=\u20091), postoperative epistaxis (n\u2009=\u20091), and fat graft site infection (n\u2009=\u20091).<\/jats:p><jats:p>\n          Conclusion\u2003This review supports the consideration of transsphenoidal surgery as an early intervention for some women with prolactin-secreting microadenoma. Indications include significant side effects of medical therapy and tumors that do not respond to standard medical management.<\/jats:p>","DOI":"10.1055\/s-0040-1722665","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:21:08Z","timestamp":1613694068000},"page":"e49-e53","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Changes in the Options for Management of Prolactin Secreting Pituitary Adenomas"],"prefix":"10.1055","volume":"83","author":[{"given":"Sherry L.","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4635-0247","authenticated-orcid":false,"given":"Wenya Linda","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1210\/jcem-14-3-265","article-title":"Syndrome characterized by galactorrhea, amenorrhea and low urinary FSH: comparison with acromegaly and normal lactation","volume":"14","author":"A P Forbes","year":"1954","journal-title":"J Clin Endocrinol Metab"},{"issue":"06","key":"ref2","first-page":"651","article-title":"The surgical management of pituitary adenomas in a series of 3,093 patients","volume":"193","author":"J A Jane 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