Prolactin-secreting pituitary adenomas: explorations and treatment (author's transl)

Prolactin-secreting pituitary adenomas have only recently been recognised as distinct entities, but probably represent the most frequent type of secreting pituitary adenomas. As they occur mainly in young women during the period of genital activity, and as therapeutic success depends on their being detected while they are still small, accent is currently being placed on early diagnosis and specific therapy. Early diagnosis depends mainly on the results of exploration of the neuro-endocrine factors of the hypothalamus-pituitary axis. Treatment, while dependent upon the attitudes of the different teams, has been transformed by the re-introduction of the trans-sphenoidal surgical approach, and the availability of bromocriptine, an orally active dopamine agonist. Their combined use has produced selective successful results in the treatment of microadenomas. Bromocriptine can reduce the size of large prolactin-secreting adenomas, and is probably a better choice than surgery because of the high failure rate of trans-sphenoid operations in the case of macroadenomas, Long-term results of these two therapeutic procedures have still to be evaluated.