Endoscopic transsphenoidal surgery versus dopamine agonist therapy for microprolactinomas
Reviewed by Gauri Mankekar

This study addresses the importance of the location of microprolactinomas in determining prognosis after surgery. Long-term dopamine agonist treatment is the current standard of treatment for microprolactinomas. However, patients often seek surgical removal. The authors of this study retrospectively analysed data of patients who had undergone endoscopic transsphenoidal removal of microprolactinomas with emphasis on the location of the adenoma on magnetic resonance imaging. The study results showed that the remission rate was significantly higher in adenomas enclosed by the pituitary gland with preoperative prolactin levels <200ng/ml compared to adenomas located lateral to the gland in the vicinity of the cavernous sinus. The authors conclude that location of the adenoma can be taken into account when planning surgery versus dopamine agonist therapy. They emphasise that expertise of the surgeon and potential for complications should also be considered when planning surgical treatment.

Endoscopic Transsphenoidal Surgery of Microprolactinomas: A reappraisal of cure rate based on radiological criteria.
Micko A, Vila G, Hoftberger R, et al.
NEUROSURGERY
2019:85(4):508-15.