Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup
Table 1
Summary of characteristics in 25 patients with invasive giant prolactinomas treated with dopamine agonists.
Case number
Gender
Age
PRL ng/mL
Three dimensions × × (mm)
Followup (month)
Treatment method
Range of tumor invasion
Maximum treatment dose
Maintenance dose (mg)
Before Tx
After Tx
Before Tx†
After Tx
% change
Pre-Tx
Post-Tx
dose (mg)
duration (month)
1
M
40
3154.8
Normal
40 × 34 × 30
0
100
143
S + BRC + RT
R-CS, TV
0
7.5
12
2.5
2
M
26
>4000
Normal
55 × 52 × 38
16 × 15 × 11
97.6
192
BRC
B-CS, Cl, TV
L-CS
7.5
60
2.5
3
M
29
16808
78.9
70 × 68 × 50
30 × 14 × 25/34 × 12 × 20
92.2
144
BRC
B-CS, Cl, SS, NC, TV
B-CS
15
10
5
4
M
24
>200
Normal
40 × 57 × 35
0
100
123
BRC
B-CS
0
7.5
60
2.5
5
F
47
>200
Normal
40 × 40 × 17
0
100
131
BRC
L-CS
0
7.5
24
1.25
6
M
34
>200
Normal
42 × 48 × 30
0
100
119
S + BRC
B-CS, SS, TV
0
7.5
119
7.5
7
M
34
3821
Normal
31 × 42 × 28
0
100
112
S + BRC
B-CS
0
7.5
12
3.75
8
M
23
3814
Normal
50 × 21 × 23
0
100
92
S + BRC
B-CS
0
5
12
1.25
9
F
52
12711.8
Normal
46 × 33 × 36
0
100
105
S + BRC
R-CS
0
5
105
5
10
F
26
>200
383
52 × 50 × 38
≈0
99.9
173
BRC + GK
R-CS, Cl, IPC, R-TL
0
12.5
96
※
11
F
22
1100
317
42 × 20 × 20
0
100
141
BRC + GK
R-CS, TV
0
15
60
※
12
F
24
>200
Normal
38 × 42 × 35
0
100
122
BRC + S
R-CS
0
20
24
2.5
13
M
48
1431.4
Normal
60 × 54 × 50
0
100
142
BRC
B-CS, TV, R-TL
0
7.5
24
0
14
F
22
>200
Normal
67 × 45 × 40
32 × 12 × 16
95
136
BRC + RT
L-CS, SS, Cl, TV, LV
TV, IS
7.5
12
5
15
M
49
>8000
Normal
65 × 55 × 45
0
100
165
BRC + RT
L-CS, SS, Cl, TV, L-TL
0
7.5
30
2.5‡
16
M
49
>4000
Normal
63 × 40 × 45
0
100
147
BRC
B-CS, SS, Cl, TV
0
7.5
35
2.5
17
M
33
>6000
Normal
58 × 49 × 51
≈0
99.9
162
S + BRC + RT
B-CS, SS, Cl, TV, NC
0
7.5
55
2.5
18
M
50
>200
Normal
50 × 30 × 30
12 × 18 × 8
96
130
S + BRC
L-CS, TV
L-CS
5
130
5
19
F
37
>8000
Normal
73 × 60 × 54
0
100
153
BRC + RT
R-CS, SS, Cl, TV, IPC, R-TL
0
7.5
7
0
20
M
15
960
141
72 × 48 × 52
40 × 25 × 20
88.9
133
S + BRC
B-CS, SS, Cl, TV, IPC, L-TL
L-CS
15
90
10
21
M
44
>200
Normal
46 × 48 × 34
0
100
119
BRC + RT
B-CS, TV, FL
0
5
12
0
22
M
46
>500
Normal
62 × 51 × 50
0
100
90
S + BRC
R-CS, R-FL, R-TL
0
17.5
60
23
M
47
>200
Normal
60 × 40 × 44
0
100
138
BRC
B-CS, SS, Cl
0
7.5
25
2.5
24
M
31
>6000
207
60 × 42 × 38
≈0
99.9
135
BRC
L-CS, TV, L-TL
0
7.5
135
7.5
25
M
40
>4000
76
55 × 52 × 30
14 × 15 × 20
95
140
BRC
B-CS, SS, Cl
R-CS
7.5
3
7.5
Mean
35.7
98.6
135.5
8.9
48.5
SEM
2.2
0.6
4.7
0.8
8.3
Most recent finding; M: male, F: f, Tx: treatment, S + BRC + RT: surgery + bromocriptine + radiotherapy, GK: gamma knife, R: right, L: left, B: bilateral, CS: cavernous sinus, SS: sphenoidal sinus, Cl: clivus, TV: third ventricule, IPC: interpeduncular cistern, FL: frontal lobe, TL: temporal lobe, NC: nose cavity, LV: lateral ventricule, and IS: intrasellar. Values represent those for tumor areas , , and , respectively. ‡This patient suffered from severe cognitive decline due to cerebral atrophy and cerebral infarction and died on March 13, 2015. This patient changed to accept cabergoline treatment (2 mg per week) due to BRC resistance and had normal PRL level. Patient withdrew BRC treatment for 35 months. Hyperprolactinemia and tumor recurrence was observed and BRC therapy was restarted. ※Those two patients had self-discontinued therapy without evidence of tumor recurrence.