RESUMO
Surgical treatment of giant pituitary adenomas is one of the most complicated problems of modern neurosurgery. Before introduction of dopamine agonists surgery was the dominating therapy. Advances in modern pharmacology allowed to approach the alternative way of management of giant prolactinomas (GP). The paper focuses on comparative analysis of results of surgical and conservative treatment of 57 patients with GP. 34 of them were operated and 23 received cabergolin as primary therapy. Assessment of neurological status, visual functions, hypopituitary disorders and prolactin level was performed. Dynamics of evaluated symptoms resulting from tumor shrinking showed that primary conservative treatment of GP is more preferable than surgical.
Assuntos
Agonistas de Dopamina/uso terapêutico , Ergolinas/uso terapêutico , Neoplasias Hipofisárias/tratamento farmacológico , Neoplasias Hipofisárias/cirurgia , Prolactina/metabolismo , Prolactinoma/tratamento farmacológico , Prolactinoma/cirurgia , Adolescente , Adulto , Idoso , Cabergolina , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/efeitos adversos , Ergolinas/administração & dosagem , Ergolinas/efeitos adversos , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/sangue , Neoplasias Hipofisárias/diagnóstico , Prolactina/sangue , Prolactinoma/sangue , Prolactinoma/diagnóstico , Resultado do Tratamento , Testes Visuais , Adulto JovemRESUMO
A prospective study of 55 patients with large and giant prolactin-secreting pituitary tumors receiving dopamine agonists as primary treatment was performed. Statistically significant data were obtained indicating decrease of prolactin level, improvement of vision, normalization of sexual function and shrinking of the tumor. Effectiveness and safety of dopamine agonists in patients with large and giant prolactinomas are proved. Also we discovered possibility of nasal CSF leak during conservative treatment.
