Short-term preoperative treatment of macroprolactinomas by dopamine agonists.

Abstract:

:During a period of 3 years, 25 patients with intra- and extrasellar macroprolactinomas were pretreated with dopamine agonists for a period of 2 to 6 1/2 weeks prior to transsphenoidal microsurgical tumor resection. Dopamine agonists were administered orally to 17 patients, intramuscularly to three patients, and both orally and intramuscularly to five patients. Repeated computerized tomography (CT) examinations revealed that all neoplasms except one cystic tumor were reduced in size during the course of dopamine-agonist administration. No complications attributable to medical pretreatment were observed. Tumor shrinkage increased the efficacy of surgery, especially in cases with considerable extrasellar extension of the adenomas. Within 3 months following adenomectomy, prolactin levels were adjusted to normal levels in 19 patients by additional low-dose treatment with dopamine agonists. Thin-collimation CT assessments performed at least 3 months after surgery showed no evidence of residual tumor tissue in 23 patients. It is concluded that administration of dopamine agonists for some weeks prior to surgery is a useful adjunct to transsphenoidal microsurgery for macroprolactinomas. The new injectable form of bromocriptine is particularly valuable for this purpose.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Fahlbusch R,Buchfelder M,Schrell U

doi

10.3171/jns.1987.67.6.0807

subject

Has Abstract

pub_date

1987-12-01 00:00:00

pages

807-15

issue

6

eissn

0022-3085

issn

1933-0693

journal_volume

67

pub_type

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