Traetment of prolactinoma 7 mm in diameter is?
Treatment of Pituitary Tumors Dopamine agonist, bromocriptine, can shrink prolactinomas in 75% of patients with macro adenomas in 6-8 weeks, but only as long as therapy is maintained Bromocriptine may also work on GH-secreting tumors with tumor shrinkage in <20% Octreotide can reduce GH levels in 71% of patients, with significant reduction in tumor volume in 30% cases Indications of surgery as an Initial Treatment GH-secreting tumors Primary Cushing's disease Any adenoma causing acute visual deterioration Non prolactin - secreting macro adenomas causing by mass effect Surgical approach of choice : Sublabial or intranasal trans-sphenoidal approach Recurrence rate : 12% (most recurrences occur 4-8 years after surgery) Radiosurgery can also be used either as primary therapy, as an adjuvant therapy after subtotal resection, or for recurrent disease. Main dose-limiting structure is proximity to the optic chiasma & optic nerves (within 3-5 mm). In this case, Fractionated EB may be indicated as an adjuvant therapy Ref : Sabiston 20th edition Pgno : 1914
Transsphenoidal resection
Dopamine agonists
Stereotactic radiosurgery
Fractionated stereotactic radiotherapy
Trauma