Cure and Hormonal Control After Prolactinoma Resection

Case Series and Systematic Review

Marisa C. Penn; Tyler Cardinal; Yanchen Zhang; Brittany Abt; Phillip A. Bonney; Patricia Lorenzo; Michelle Lin; Jack Rosner; Martin Weiss; Gabriel Zada; John D. Carmichael


J Endo Soc. 2021;5(10) 

In This Article


This retrospective series of 56 prolactinoma patients treated surgically at a tertiary pituitary center suggests that surgical resection can be an effective treatment for prolactinoma patients. CSI status, tumor size, POD1 prolactin levels, and EOR can be used to predict surgical cure. In particular, POD1 prolactin levels greater than 7.6 ng/mL can reliably predict that a patient will not attain surgical cure. We suggest that significant preoperative prolactin elevations (> 500 ng/mL for surgical cure and > 1000 ng/mL for biochemical control regardless of postoperative DA therapy) may decrease the likelihood of surgical cure or biochemical control irrespective of DA therapy. Although surgical resection of prolactinomas is safe at experienced pituitary centers, it should be reserved for selected cases in which patients can achieve disease control, relief of symptoms of mass effect, or reduction of DA dosage. Realistic outcomes regarding biochemical control and ongoing dependence on medications should be provided to patients to aid in decision making.