Management of prolactin-secreting pituitary adenomas with surgery and bromocriptine

Eighty-six women with amenorrhoea, galactorrhoea and infertility were evaluated during the past two years. Hyperprolactinaemia was encountered in 30 cases. All hyperprolactinaemic patiens underwent hypocycloidal polytomography and C-T scan. Fourteen cases with abnormal radiologic findings had suggestive evidence of pituitary adenomas. Ten cases were categorized as microprolactinoma (tumour measuring less than 10 mm), and four were macroprolactinoma. Transsphenoidal microsurgical removal of tumours were carried out in three cases of macroprolactinoma and one case of microprolactinoma. The remaining nine cases of microprolactinoma and one case of macroprolactinoma (pregnancy for six months) were treated with bromocriptine. Both surgery and bromocriptine therapy could lower the prolactin values. Twelve patients had return of menses and resolution of galactorrhoea. One case of macroplactinoma macroprolactinoma panhypopituitarism and did not have menstrual restoration. Two patients became pregnant after bromocriptine therapy. None of our cases showed tumour progression during the follow-up period. The last case, who had visual deterioration and evidence of tumour expansion during pregnancy, was transferred from an outside clinic. Her vision was improved after one month of bromocriptine treatment. The average duration of follow-up in our series is 10 months and probably a longer term of observation will be more desirable.