{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:42:47Z","timestamp":1793216567892,"version":"4.5.0"},"reference-count":135,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,13]],"date-time":"2022-08-13T00:00:00Z","timestamp":1660348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Prolactinomas are the commonest form of pituitary neuroendocrine tumor (PitNET), representing approximately half of such tumors. Dopamine agonists (DAs) have traditionally been the primary treatment for the majority of prolactinomas, with surgery considered the second line. The aim of this review is to examine the historical and modern management of prolactinomas, including medical therapy with DAs, transsphenoidal surgery, and multimodality therapy for the treatment of aggressive prolactinomas and metastatic PitNETs, with an emphasis on the efficacy, safety, and future directions of current therapeutic modalities. DAs have been the mainstay of prolactinoma management since the 1970s, initially with bromocriptine and more recently with cabergoline. Cabergoline normalizes prolactin in up to 85% of patients and causes tumor shrinkage in up to 80%. Primary surgical resection of microprolactinomas and enclosed macroprolactinomas performed by experienced pituitary neurosurgeons have similar remission rates to cabergoline. Aggressive prolactinomas and metastatic PitNETS should receive multimodality therapy including high dose cabergoline, surgery, radiation therapy (preferably using stereotactic radiosurgery where suitable), and temozolomide. DAs remain a reliable mode of therapy for most prolactinomas but results from transsphenoidal surgery in expert hands have improved considerably over the last one to two decades. Surgery should be strongly considered as primary therapy, particularly in the setting of microprolactinomas, non-invasive macroprolactinomas, or prior to attempting pregnancy, and has an important role in the management of DA resistant and aggressive prolactinomas.<\/jats:p>","DOI":"10.3390\/medicina58081095","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T03:33:20Z","timestamp":1660534400000},"page":"1095","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Treatment of Prolactinoma"],"prefix":"10.3390","volume":"58","author":[{"given":"Warrick J.","family":"Inder","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba 4102, Australia"},{"name":"Academy for Medical Education, Faculty of Medicine, The University of Queensland, Herston 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Royal Brisbane and Women\u2019s Hospital, Herston 4029, Australia"},{"name":"Faculty of Medicine, The University of Queensland, Herston 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1172\/JCI106643","article-title":"Human prolactin: Measurement in plasma by in vitro bioassay","volume":"50","author":"Kleinberg","year":"1971","journal-title":"J. Clin. Investig."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1210\/jcem-33-6-996","article-title":"Increased serum prolactin after administration of synthetic thyrotropin releasing hormone (TRH) in man","volume":"33","author":"Jacobs","year":"1971","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/0196-9781(84)90240-7","article-title":"Role of vasoactive intestinal polypeptide (VIP) in regulating the pituitary function in man","volume":"5","author":"Kato","year":"1984","journal-title":"Peptides"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"T101","DOI":"10.1530\/JOE-15-0213","article-title":"60 years of neuroendocrinology: The hypothalamo-prolactin axis","volume":"226","author":"Grattan","year":"2015","journal-title":"J. Endocrinol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/0002-9378(77)90594-4","article-title":"Pattern of increase in circulating prolactin levels during human gestation","volume":"129","author":"Rigg","year":"1977","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1210\/jcem-62-4-653","article-title":"A prospective longitudinal study of the release of oxytocin and prolactin in response to infant suckling in long term lactation","volume":"62","author":"Johnston","year":"1986","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1365-2265.1986.tb01670.x","article-title":"Breast stimulation in cycling women, pregnant women and a woman with induced lactation: Pattern of release of oxytocin, prolactin and luteinizing hormone","volume":"25","author":"Amico","year":"1986","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/BF03350070","article-title":"Thoracic stimulation and prolactin secretion","volume":"12","author":"Kapcala","year":"1989","journal-title":"J. Endocrinol. Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3109\/09513598909152463","article-title":"Hyperprolactinemia, galactorrhea and amenorrhea in women with a spinal cord injury","volume":"3","author":"Berezin","year":"1989","journal-title":"Gynecol. Endocrinol."},{"key":"ref_10","first-page":"S46","article-title":"The effect of seizures on hormones","volume":"32","author":"Pritchard","year":"1991","journal-title":"Epilepsia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1046\/j.1365-2265.1996.642464.x","article-title":"Plasma cortisol, PRL, ACTH, AVP and corticotrophin releasing hormone responses to direct current cardioversion and electroconvulsive therapy","volume":"44","author":"Florkowski","year":"1996","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0149-7634(01)00036-7","article-title":"Orgasm-induced prolactin secretion: Feedback control of sexual drive?","volume":"26","author":"Kruger","year":"2002","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.ecl.2020.04.002","article-title":"The Epidemiology of Pituitary Adenomas","volume":"49","author":"Daly","year":"2020","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/ajo.13416","article-title":"A cannulated prolactin series reduces the need for further investigations in women with infertility and lowers the number of false positive screening prolactin measurements","volume":"61","author":"Searle","year":"2021","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1365-2265.2006.02627.x","article-title":"Do the limits of serum prolactin in disconnection hyperprolactinaemia need re-definition? A study of 226 patients with histologically verified non-functioning pituitary macroadenoma","volume":"65","author":"Karavitaki","year":"2006","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1111\/cen.12009","article-title":"Gender differences in presentation and outcome of nonfunctioning pituitary macroadenomas","volume":"78","author":"Caputo","year":"2013","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11102-019-01024-z","article-title":"Biochemical diagnosis in prolactinomas: Some caveats","volume":"23","author":"Petersenn","year":"2020","journal-title":"Pituitary"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1016\/S0344-0338(11)81066-6","article-title":"Apparently silent somatotroph adenomas","volume":"187","author":"Pagesy","year":"1991","journal-title":"Pathol. Res. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1038\/modpathol.2015.151","article-title":"Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal Pit-1 lineage adenomas","volume":"29","author":"Mete","year":"2016","journal-title":"Mod. Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"830","DOI":"10.3109\/00048674.2011.589044","article-title":"Antipsychotic-induced hyperprolactinaemia","volume":"45","author":"Inder","year":"2011","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/j.1365-2265.1976.tb03877.x","article-title":"Effect of metroclopramide on serum prolactin levels in humans","volume":"5","author":"Delitala","year":"1976","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1055\/s-0029-1211358","article-title":"Identification of macroprolactin in a patient with asymptomatic hyperprolactinemia as a stable PRL-IgG complex","volume":"103","author":"Bonhoff","year":"1995","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1210\/jcem.87.2.8272","article-title":"Macroprolactinemia revisited: A study on 106 patients","volume":"87","author":"Selim","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1210\/jc.2014-3344","article-title":"Neuroendocrine causes of amenorrhea--an update","volume":"100","author":"Fourman","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0015-0282(16)59292-9","article-title":"The natural history of untreated microprolactinomas","volume":"48","author":"Sisam","year":"1987","journal-title":"Fertil. Steril."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11102-019-01009-y","article-title":"Prolactinomas in males: Any differences?","volume":"23","author":"Shimon","year":"2020","journal-title":"Pituitary"},{"key":"ref_27","first-page":"2102","article-title":"Sex-related difference in the growth of prolactinomas: A clinical and proliferation marker study","volume":"82","author":"Delgrange","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1530\/EJE-09-0012","article-title":"Characterization of resistance to the prolactin-lowering effects of cabergoline in macroprolactinomas: A study in 122 patients","volume":"160","author":"Delgrange","year":"2009","journal-title":"Eur. J. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1111\/j.1365-2265.1990.tb03914.x","article-title":"Screening for multiple endocrine neoplasia type 1 in patients with recognized pituitary adenoma","volume":"33","author":"Andersen","year":"1990","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1210\/clinem\/dgac162","article-title":"MEN4, the MEN1 mimicker; a case series of 3 phenotypically heterogenous patients with unique CDKN1B mutations","volume":"107","author":"Seabrook","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E710","DOI":"10.1210\/jc.2014-4297","article-title":"Pituitary adenoma with paraganglioma\/pheochromocytoma (3PAs) and succinate dehydrogenase defects in humans and mice","volume":"100","author":"Xekouki","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1210\/jc.2006-2513","article-title":"Aryl hydrocarbon receptor-interacting protein gene mutations in familial isolated pituitary adenomas: Analysis in 73 families","volume":"92","author":"Daly","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.ecl.2020.05.005","article-title":"Update on the Genetics of Pituitary Tumors","volume":"49","author":"Barry","year":"2020","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1136\/bmj.2.5916.419","article-title":"Long-term treatment of galactorrhoea and hypogonadism with bromocriptine","volume":"2","author":"Thorner","year":"1974","journal-title":"Br. Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/S0140-6736(79)92976-3","article-title":"Regression of pituitary prolactinoma after treatment with bromocriptine","volume":"1","author":"Landolt","year":"1979","journal-title":"Lancet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0140-6736(79)90120-X","article-title":"Reduction of pituitary-tumour size in patients with prolactinomas and acromegaly treated with bromocriptine with or without radiotherapy","volume":"2","author":"Wass","year":"1979","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0015-0282(16)60909-3","article-title":"Reduction in the size of prolactin-producing pituitary tumor after Cabergoline administration","volume":"52","author":"Melis","year":"1989","journal-title":"Fertil. Steril."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1056\/NEJM199410063311403","article-title":"A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea","volume":"331","author":"Webster","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"668","DOI":"10.7326\/0003-4819-112-9-668","article-title":"Treatment of prolactin-secreting pituitary macroadenomas with the long-acting non-ergot dopamine agonist CV 205-502","volume":"112","author":"Vance","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1365-2265.1990.tb00495.x","article-title":"CV205-502, a new non-ergot dopamine agonist, reduces prolactinoma size in man","volume":"33","author":"Barnett","year":"1990","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1210\/jcem.82.3.3822","article-title":"Prolactinomas resistant to standard dopamine agonists respond to chronic cabergoline treatment","volume":"82","author":"Colao","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_42","first-page":"2247","article-title":"Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: A prospective study in 110 patients","volume":"85","author":"Colao","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3574","DOI":"10.1210\/jcem.82.11.4368","article-title":"Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage","volume":"82","author":"Colao","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"236","DOI":"10.20945\/2359-3997000000032","article-title":"Controversial issues in the management of hyperprolactinemia and prolactinomas\u2014An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism","volume":"62","author":"Vilar","year":"2018","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_45","first-page":"286","article-title":"Cabergoline treatment rapidly improves gonadal function in hyperprolactinemic males: A comparison with bromocriptine","volume":"138","author":"Colao","year":"1998","journal-title":"Eur. J. Endocrinol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1159\/000495775","article-title":"Management of Dopamine Agonist-Resistant Prolactinoma","volume":"109","author":"Maiter","year":"2019","journal-title":"Neuroendocrinology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4721","DOI":"10.1210\/jc.2007-2758","article-title":"Prospective study of high-dose cabergoline treatment of prolactinomas in 150 patients","volume":"93","author":"Ono","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/S0015-0282(16)58113-8","article-title":"Vaginal cabergoline in the treatment of hyperprolactinemic patients intolerant to oral dopaminergics","volume":"65","author":"Motta","year":"1996","journal-title":"Fertil. Steril."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1530\/eje.0.1350413","article-title":"Prolactinomas resistant to bromocriptine: Long-term efficacy of quinagolide and outcome of pregnancy","volume":"135","author":"Morange","year":"1996","journal-title":"Eur. J. Endocrinol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1046\/j.1365-2265.2000.01016.x","article-title":"The effect of quinagolide and cabergoline, two selective dopamine receptor type 2 agonists, in the treatment of prolactinomas","volume":"53","author":"Landi","year":"2000","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11102-019-01010-5","article-title":"Prolactinomas in pregnancy: Considerations before conception and during pregnancy","volume":"23","author":"Glezer","year":"2020","journal-title":"Pituitary"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1056\/NEJMoa062222","article-title":"Dopamine agonists and the risk of cardiac-valve regurgitation","volume":"356","author":"Schade","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1056\/NEJMoa054830","article-title":"Valvular heart disease and the use of dopamine agonists for Parkinson\u2019s disease","volume":"356","author":"Zanettini","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S2213-8587(14)70212-8","article-title":"The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: A systematic review and additional clinical data","volume":"3","author":"Caputo","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1210\/js.2018-00139","article-title":"The Third Case of Cabergoline-Associated Valvulopathy: The Value of Routine Cardiovascular Examination for Screening","volume":"2","author":"Caputo","year":"2018","journal-title":"J. Endocr. Soc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1111\/cen.13940","article-title":"Echocardiography and monitoring patients receiving dopamine agonist therapy for hyperprolactinaemia: A joint position statement of the British Society of Echocardiography, the British Heart Valve Society and the Society for Endocrinology","volume":"90","author":"Steeds","year":"2019","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e711","DOI":"10.1210\/clinem\/dgaa882","article-title":"Incidence of Cabergoline-Associated Valvulopathy in Primary Care Patients With Prolactinoma Using Hard Cardiac Endpoints","volume":"106","author":"Stiles","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1530\/EO-21-0038","article-title":"Dopamine agonist therapy for prolactinomas: Do we need to rethink the place of surgery in prolactinoma management?","volume":"2","year":"2022","journal-title":"Endocr. Oncol."},{"key":"ref_59","unstructured":"(2000). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [4th ed.]."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1002\/mds.22571","article-title":"Validation of the questionnaire for impulsive-compulsive disorders in Parkinson\u2019s disease","volume":"24","author":"Weintraub","year":"2009","journal-title":"Mov. Disord."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.1210\/clinem\/dgz076","article-title":"Impulse Control Disorders in Dopamine Agonist-Treated Hyperprolactinemia: Prevalence and Risk Factors","volume":"105","author":"Baranoff","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s12020-016-1088-1","article-title":"Dopa-testotoxicosis: Disruptive hypersexuality in hypogonadal men with prolactinomas treated with dopamine agonists","volume":"55","author":"Chapman","year":"2017","journal-title":"Endocrine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/cen.12375","article-title":"Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary adenomas: A case-control study","volume":"80","author":"Bancos","year":"2014","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1007\/s12020-018-1744-8","article-title":"Impulse control disorders in patients with prolactinoma receiving dopamine agonist therapy: A prospective study with 1 year follow-up","volume":"62","author":"Celik","year":"2018","journal-title":"Endocrine"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/BF02238717","article-title":"Bromocriptine and psychosis: A literature review","volume":"66","author":"Boyd","year":"1995","journal-title":"Psychiatr. Q."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1136\/bmj.289.6452.1101","article-title":"Psychotic reactions during treatment of pituitary tumours with dopamine agonists","volume":"289","author":"Turner","year":"1984","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"bcr0720103185","DOI":"10.1136\/bcr.07.2010.3185","article-title":"Treating prolactinoma and psychosis: Medication and cognitive behavioural therapy","volume":"2011","author":"Nieman","year":"2011","journal-title":"BMJ Case Rep."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"E54","DOI":"10.1176\/appi.neuropsych.11110348","article-title":"Cabergoline-induced psychosis in a patient with undiagnosed depression","volume":"24","author":"Bilal","year":"2012","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"350","DOI":"10.4103\/0253-7176.207314","article-title":"Cabergoline-induced Mania in a Patient of Pituitary Microadenoma","volume":"39","author":"Mohapatra","year":"2017","journal-title":"Indian J. Psychol. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s11102-010-0261-4","article-title":"Effect of dopaminergic drug treatment on surgical findings in prolactinomas","volume":"14","author":"Menucci","year":"2011","journal-title":"Pituitary"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s00701-012-1450-x","article-title":"Transsphenoidal surgery for microprolactinomas in women: Results and prognosis","volume":"154","author":"Tamasauskas","year":"2012","journal-title":"Acta Neurochir. (Wien.)"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"bcr2017220971","DOI":"10.1136\/bcr-2017-220971","article-title":"Cabergoline-induced fibrosis of prolactinomas: A neurosurgical perspective","volume":"2017","author":"Mohan","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/j.clineuro.2013.02.016","article-title":"Transsphenoidal microsurgical results of female patients with prolactinomas","volume":"115","author":"Ikeda","year":"2013","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4158\/EP13165.RA","article-title":"Effect of the preoperative use of dopamine agonists in the postoperative course of prolactinomas: A systematic review","volume":"20","author":"Carija","year":"2014","journal-title":"Endocr. Pract."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1016\/j.wneu.2021.07.035","article-title":"Determinants of Surgical Remission in Prolactinomas: A Systematic Review and Meta-Analysis","volume":"154","author":"Wright","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11102-019-01016-z","article-title":"Surgery for prolactinomas: A better choice?","volume":"23","author":"Honegger","year":"2020","journal-title":"Pituitary"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"3829","DOI":"10.1210\/jc.2007-0373","article-title":"Nonsurgical cerebrospinal fluid rhinorrhea in invasive macroprolactinoma: Incidence, radiological, and clinicopathological features","volume":"92","author":"Suliman","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2012.4.FOCUS1268","article-title":"Spontaneous and medically induced cerebrospinal fluid leakage in the setting of pituitary adenomas: Review of the literature","volume":"32","author":"Lam","year":"2012","journal-title":"Neurosurg. Focus."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1530\/EJE-09-0923","article-title":"Pregnancy and pituitary disorders","volume":"162","author":"Karaca","year":"2010","journal-title":"Eur. J. Endocrinol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1111\/j.1471-0528.1976.tb00913.x","article-title":"Plasma prolactin levels during pregnancy","volume":"83","author":"Biswas","year":"1976","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s12020-014-0334-7","article-title":"Prolactinomas, cabergoline, and pregnancy","volume":"47","author":"Glezer","year":"2014","journal-title":"Endocrine"},{"key":"ref_82","first-page":"282","article-title":"Prolactin and deficient luteal function","volume":"53","author":"Wyss","year":"1979","journal-title":"Obstet. Gynecol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S0015-0282(16)46753-1","article-title":"Prolactin in the evaluation of luteal phase in infertility","volume":"39","author":"Vanrell","year":"1983","journal-title":"Fertil. Steril."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"452","DOI":"10.3109\/07853899809002486","article-title":"Treatment of prolactinomas","volume":"30","author":"Colao","year":"1998","journal-title":"Ann. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"R205","DOI":"10.1530\/EJE-14-0848","article-title":"Endocrinology in pregnancy: Management of the pregnant patient with a prolactinoma","volume":"172","author":"Molitch","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/bmj.2.6193.771","article-title":"Pregnancy in patients presenting with hyperprolactinaemia","volume":"2","author":"Thorner","year":"1979","journal-title":"Br. Med. J."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.beem.2011.05.011","article-title":"Prolactinoma in pregnancy","volume":"25","author":"Molitch","year":"2011","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.ecl.2019.05.004","article-title":"Pituitary Tumors in Pregnancy","volume":"48","author":"Huang","year":"2019","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1159\/000180100","article-title":"Follow-up of children born of bromocriptine-treated mothers","volume":"22","author":"Raymond","year":"1985","journal-title":"Horm. Res."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1471-0528.1994.tb13626.x","article-title":"Cabergoline treated hyperprolactinaemia results in pregnancy in a bromocriptine intolerant patient after seventeen years of infertility","volume":"101","author":"Jones","year":"1994","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/j.1365-2265.2010.03808.x","article-title":"Outcome of 100 pregnancies initiated under treatment with cabergoline in hyperprolactinaemic women","volume":"73","author":"Lebbe","year":"2010","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1080\/09513590.2016.1254177","article-title":"Pregnancy and tumor outcomes in infertile women with macroprolactinoma on cabergoline therapy","volume":"33","author":"Rastogi","year":"2017","journal-title":"Gynecol. Endocrinol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-21-0462","article-title":"ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy","volume":"185","author":"Luger","year":"2021","journal-title":"Eur. J. Endocrinol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"228","DOI":"10.2165\/00002018-199614040-00003","article-title":"A comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinaemia and inhibition of lactation","volume":"14","author":"Webster","year":"1996","journal-title":"Drug Saf."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1055\/a-0794-7587","article-title":"Pituitary Disease in Pregnancy: Special Aspects of Diagnosis and Treatment?","volume":"79","author":"Petersenn","year":"2019","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1210\/jc.2010-1692","article-title":"Diagnosis and treatment of hyperprolactinemia: An Endocrine Society clinical practice guideline","volume":"96","author":"Melmed","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1530\/EJE-20-0125","article-title":"Efficacy and safety of dopamine agonists in patients treated with antipsychotics and presenting a macroprolactinoma","volume":"183","author":"Allard","year":"2020","journal-title":"Eur. J. Endocrinol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1037\/a0033448","article-title":"Effects of cabergoline on hyperprolactinemia, psychopathology, and sexual functioning in schizophrenic patients","volume":"21","author":"Kalkavoura","year":"2013","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1176\/appi.psy.50.4.317","article-title":"Evidence for the partial dopamine-receptor agonist aripiprazole as a first-line treatment of psychosis in patients with iatrogenic or tumorogenic hyperprolactinemia","volume":"50","author":"Hoffer","year":"2009","journal-title":"Psychosomatics"},{"key":"ref_100","first-page":"160028","article-title":"Successful treatment of a prolactinoma with the antipsychotic drug aripiprazole","volume":"2016","author":"Bakker","year":"2016","journal-title":"Endocrinol. Diabetes Metab. Case Rep."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1056\/NEJMoa022657","article-title":"Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia","volume":"349","author":"Colao","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/j.1365-2265.2007.02905.x","article-title":"Predictors of remission of hyperprolactinaemia after long-term withdrawal of cabergoline therapy","volume":"67","author":"Colao","year":"2007","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"P1","DOI":"10.1530\/EJE-21-0977","article-title":"Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: Prolactin-secreting tumors","volume":"186","author":"Cozzi","year":"2022","journal-title":"Eur. J. Endocrinol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1046\/j.1365-2265.1996.738559.x","article-title":"The outcome of hypophysectomy for prolactinomas in the era of dopamine agonist therapy","volume":"44","author":"Soule","year":"1996","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0090-3019(96)00452-1","article-title":"Endoscopic pituitary surgery: An early experience","volume":"47","author":"Jho","year":"1997","journal-title":"Surg. Neurol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3171\/jns.1997.87.1.0044","article-title":"Endoscopic endonasal transsphenoidal surgery: Experience with 50 patients","volume":"87","author":"Jho","year":"1997","journal-title":"J. Neurosurg."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"R89","DOI":"10.1530\/EJE-16-0087","article-title":"Therapy of Endocrine disease: Surgery in microprolactinomas: Effectiveness and risks based on contemporary literature","volume":"175","author":"Tampourlou","year":"2016","journal-title":"Eur. J. Endocrinol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s11102-018-0904-4","article-title":"The experience with transsphenoidal surgery and its importance to outcomes","volume":"21","author":"Honegger","year":"2018","journal-title":"Pituitary"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1530\/EJE-07-0248","article-title":"Operative treatment of prolactinomas: Indications and results in a current consecutive series of 212 patients","volume":"158","author":"Kreutzer","year":"2008","journal-title":"Eur. J. Endocrinol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/j.1365-2265.2006.02562.x","article-title":"Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas","volume":"65","author":"Casanueva","year":"2006","journal-title":"Clin. Endocrinol. (Oxf.)"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"3709","DOI":"10.1210\/jc.2016-2008","article-title":"Dopamine Agonists Can Reduce Cystic Prolactinomas","volume":"101","author":"Faje","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s12020-019-02076-8","article-title":"Surgical management considerations in cystic prolactinomas-a single center case series","volume":"67","author":"Nevzati","year":"2020","journal-title":"Endocrine"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s11102-021-01170-3","article-title":"Pituitary Society Delphi Collaborative, G. Pituitary Society Delphi Survey: An international perspective on endocrine management of patients undergoing transsphenoidal surgery for pituitary adenomas","volume":"25","author":"Tritos","year":"2022","journal-title":"Pituitary"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1007\/s40618-021-01569-6","article-title":"First-line surgery in prolactinomas: Lessons from a long-term follow-up study in a tertiary referral center","volume":"44","author":"Andereggen","year":"2021","journal-title":"J. Endocrinol. Investig."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-17-0796","article-title":"European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas","volume":"178","author":"Raverot","year":"2018","journal-title":"Eur. J. Endocrinol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s11102-019-01000-7","article-title":"Aggressive prolactinomas: How to manage?","volume":"23","author":"Lasolle","year":"2020","journal-title":"Pituitary"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s12022-022-09703-7","article-title":"Overview of the 2022 WHO Classification of Pituitary Tumors","volume":"33","author":"Asa","year":"2022","journal-title":"Endocr. Pathol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s11102-019-00987-3","article-title":"Dopamine agonist resistant prolactinomas: Any alternative medical treatment?","volume":"23","author":"Souteiro","year":"2020","journal-title":"Pituitary"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s12020-022-03080-1","article-title":"Resistant prolactinomas: A case series of 26 patients","volume":"77","author":"Eshkoli","year":"2022","journal-title":"Endocrine"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1007\/s11102-021-01165-0","article-title":"Anastrozole as add-on therapy for cabergoline-resistant prolactin-secreting pituitary adenomas: Real-life experience in male patients","volume":"24","author":"Ceccato","year":"2021","journal-title":"Pituitary"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1159\/000514591","article-title":"Prolactin Response to Metformin in Cabergoline-Resistant Prolactinomas: A Pilot Study","volume":"112","author":"Portari","year":"2022","journal-title":"Neuroendocrinology"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/S0959-8049(05)80198-4","article-title":"Temozolomide: A new oral cytotoxic chemotherapeutic agent with promising activity against primary brain tumours","volume":"29","author":"Newlands","year":"1993","journal-title":"Eur. J. Cancer"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/S1470-2045(06)70728-8","article-title":"Temozolomide: A novel treatment for pituitary carcinoma","volume":"7","author":"Lim","year":"2006","journal-title":"Lancet Oncol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1530\/EJE-16-0979","article-title":"Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas","volume":"176","author":"Lasolle","year":"2017","journal-title":"Eur. J. Endocrinol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1210\/jc.2018-02461","article-title":"Effect of Everolimus in Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas","volume":"104","author":"Zhang","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1530\/EJE-07-0806","article-title":"Somatostatinergic ligands in dopamine-sensitive and -resistant prolactinomas","volume":"158","author":"Fusco","year":"2008","journal-title":"Eur. J. Endocrinol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.ando.2018.07.013","article-title":"Pasireotide: A potential therapeutic alternative for resistant prolactinoma","volume":"80","author":"Lasolle","year":"2019","journal-title":"Ann. Endocrinol. (Paris)"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"K21","DOI":"10.1530\/EJE-19-0279","article-title":"Excellent response to pasireotide therapy in an aggressive and dopamine-resistant prolactinoma","volume":"181","author":"Coopmans","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"C1","DOI":"10.1530\/EJE-19-0359","article-title":"Confirmation of a new therapeutic option for aggressive or dopamine agonist-resistant prolactin pituitary neuroendocrine tumors","volume":"181","author":"Raverot","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1530\/EC-19-0065","article-title":"Peptide receptor radionuclide therapy for aggressive pituitary tumors: A monocentric experience","volume":"8","author":"Giuffrida","year":"2019","journal-title":"Endocr. Connect."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"e917","DOI":"10.1210\/clinem\/dgaa805","article-title":"EGFR\/ErbB2-Targeting Lapatinib Therapy for Aggressive Prolactinomas","volume":"106","author":"Cooper","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Duhamel, C., Ilie, M.D., Salle, H., Nassouri, A.S., Gaillard, S., Deluche, E., Assaker, R., Mortier, L., Cortet, C., and Raverot, G. (2020). Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature. J. Pers. Med., 10.","DOI":"10.3390\/jpm10030088"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Goichot, B., Taquet, M.C., Baltzinger, P., Baloglu, S., Gravaud, M., Malouf, G.G., Noel, G., and Imperiale, A. (2021). Should pituitary carcinoma be treated using a NET-like approach? A case of complete remission of a metastatic malignant prolactinoma with multimodal therapy including immunotherapy. Clin. Endocrinol. (Oxf.), early view.","DOI":"10.1111\/cen.14645"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s11102-011-0348-6","article-title":"Radiotherapy for prolactin-secreting pituitary tumors","volume":"15","author":"Chao","year":"2012","journal-title":"Pituitary"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"801","DOI":"10.3171\/2021.2.JNS204440","article-title":"Stereotactic radiosurgery for secretory pituitary adenomas: Systematic review and International Stereotactic Radiosurgery Society practice recommendations","volume":"136","author":"Mathieu","year":"2022","journal-title":"J. Neurosurg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1095\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:08:27Z","timestamp":1760141307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,13]]},"references-count":135,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58081095"],"URL":"https:\/\/doi.org\/10.3390\/medicina58081095","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,13]]}}}