Management of Prolactinomas

[madman]

This guideline focuses on managing prolactin-secreting pituitary adenomas in adults, excluding pregnancy. The panel recommends cabergoline as the first-choice pharmacological treatment, with bromocriptine as an alternative for intolerant patients. Medication and surgery are suggested as suitable first-line treatments for non-invasive adenomas. Pituitary tumor resection is recommended for certain cases, and progressive disease requires a multidisciplinary approach with surgery, radiotherapy, dopamine agonists, and potentially temozolomide. The guideline is intended for endocrinologists, neurosurgeons, gynecologists, general practitioners, and patients in various healthcare settings.

 

[madman]

Table 1. Common PRL-rising medications.

 

[madman]

Table 2. Costs of therapeutic procedures – microprolactinoma.

 

[madman]

Table 3. Costs of therapeutic procedures – macroprolactinoma.

 

[madman]

Table 4. Results of cost-efficacy analysis for therapeutic actions.

 

[Nelson Vergel]

Long-term use of clomiphene in male macroprolactinomas with persistent hypogonadism - Endocrine

Background Men with macroprolactinoma can present persistent hypogonadism despite normoprolactinemia achieved with clinical and/or neurosurgical treatment. Usually, testosterone replacement therapy is indicated. Nevertheless, although off-label, clomiphene citrate (CC), a selective estrogen...

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