{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T23:30:34Z","timestamp":1771457434370,"version":"3.50.1"},"reference-count":43,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Region V\u00e4rmland County Council and Karolinska Institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To describe the clinical presentation and treatment outcomes in a nationwide cohort of patients with giant prolactinomas.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Register-based study of patients with giant prolactinomas [serum prolactin (PRL) &amp;gt; 1000 \u00b5g\/L, tumor diameter \u226540 mm] identified in the Swedish Pituitary Register 1991-2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eighty-four patients [mean age 47 (SD \u00b116) years, 89% men] were included in the study. At diagnosis, the median PRL was 6305 \u00b5g\/L (range 1450-253 000), the median tumor diameter was 47 mm (range 40-85), 84% of the patients had hypogonadotropic hypogonadism, and 71% visual field defects. All patients were treated with a dopamine agonist (DA) at some point. Twenty-three (27%) received 1 or more additional therapies, including surgery (n = 19), radiotherapy (n = 6), other medical treatments (n = 4), and chemotherapy (n = 2). Ki-67 was \u226510% in 4\/14 tumors. At the last follow-up [median 9 years (interquartile range (IQR) 4-15)], the median PRL was 12 \u00b5g\/L (IQR 4-126), and the median tumor diameter was 22 mm (IQR 3-40). Normalized PRL was achieved in 55%, significant tumor reduction in 69%, and combined response (normalized PRL and significant tumor reduction) in 43%. In the primary DA-treated patients (n = 79), the reduction in PRL or tumor size after the first year predicted the combined response at the last follow-up (P &amp;lt; .001 and P = .012, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>DAs effectively reduced PRL and tumor size, but approximately 1 patient out of 4 needed multimodal treatment. Our results suggest that the response to DA after 1 year is useful for identifying patients who need more careful monitoring and, in some cases, additional treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad393","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T04:03:28Z","timestamp":1688529808000},"page":"e1506-e1514","source":"Crossref","is-referenced-by-count":16,"title":["Long-term Follow-up of 84 Patients With Giant Prolactinomas\u2014A Swedish Nationwide Study"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6957-4411","authenticated-orcid":false,"given":"Christos","family":"Himonakos","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , 171 76, Stockholm , Sweden"},{"name":"Department of Internal Medicine, Center for Endocrinology and Diabetes, Karlstad Central Hospital , 651 85, Karlstad , 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Ed\u00e9n","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University and Uppsala University Hospital , 751 85, Uppsala , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8732-7361","authenticated-orcid":false,"given":"Bertil","family":"Ekman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , 581 83, Link\u00f6ping , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Emilsson","sequence":"additional","affiliation":[{"name":"Department of General Practice, Institute of Health and Society, University of Oslo , 0318, Oslo , Norway"},{"name":"Nys\u00e4ter Health Care Center and Center for Clinical Research, County Council of V\u00e4rmland , 651 85, Karlstad , Sweden"},{"name":"Department 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