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August 17, 1984

Long-term Follow-up of Transsphenoidal Selective Adenomectomy for Prolactinoma

Author Affiliations

From the Division of Endocrinology, Department of Medicine (Drs Rodman, Molitch, Biller, and Reichlin), and the Department of Neurosurgery (Dr Post), New England Medical Center and Tufts University School of Medicine, Boston. Dr Post is now with the Neurological Institute, Columbia Presbyterian Medical Center, New York. Dr Molitch is now with the Center for Endocrinology, Metabolism, and Nutrition, Northwestern University Medical School, Chicago.

JAMA. 1984;252(7):921-924. doi:10.1001/jama.1984.03350070039020

Although transsphenoidal selective resection of prolactinoma has high cure rates and low morbidity, the frequency of late recurrence of adenoma is controversial. Long-term follow-up data were available on 29 of our patients having initial return to normal prolactin levels after microadenoma resection; in 24, prolactin levels remained normal at 50 ± months' (range, 11 to 81 months) follow-up. Five patients manifested hyperprolactinemia again after intervals of six to 16 months. In five patients with normal prolactin levels immediately after macroadenoma resection, who were available for long-term follow-up, prolactin levels remained normal in four at 41 ±3 months; one patient had a relapse 78 months after surgery. Testing of prolactin secretory dynamics six weeks postoperatively was not predictive of who would suffer relapse. It is not known whether these relapses are due to regrowth of tumor remnants or represent new tumor formation.

(JAMA 1984;252:921-924)