Research Article

Surgical Management of Giant Prolactinomas: A Descriptive Study

Table 2

Preoperative and operative treatment course for patients with giant prolactinoma.

Case noPreoperative DA dose and durationPRL after initial DA (μg/L)Tumor volume after initial DA (cm3)Indication for surgerySurgery typeTumor pathology features

1N/AN/AN/AMisdiagnosis, vision lossCraniotomy, incomplete resectionBenign, diffuse PRL stain, no co-staining
2Cab 2.5 mg/wk for 36 mos4,156
(19% increase)
N/A–not measuredDA resistance and intolerance, vision loss, tumor apoplexyTranssphenoidal endoscopy, incomplete resectionBenign, diffuse PRL stain, no co-staining, Ki-67 1-2%
Tumor fibrosis
3Cab 1 mg/wk for 3 mos262 (76% decrease)39.4
(44% increase)
DA resistance, vision lossTranssphenoidal using microscopy, incomplete resectionBenign, diffuse PRL stain, ACTH co-staining
(No co-secretion)
4Cab 1 mg/wk for 3 weeks172
(93% decrease)
20.0
(12% decrease)
CSF leak, DA intolerance, vision lossTranssphenoidal using microscopy, incomplete resectionBenign, diffuse PRL stain, GH and TSH co-staining (no co-secretion)
5Cab 2 mg/wk for 2 weeks364
(47% decrease)
37.2
(20% increase)
DA resistance, vision lossTranssphenoidal endoscopy, incomplete resectionBenign, diffuse PRL stain, no co-staining
6Cab 3.5 mg/wk for 18 mos5,754
(>56% decrease)
27.4
(11% decrease)
DA resistance and intoleranceTranssphenoidal endoscopy, incomplete resectionBenign, diffuse PRL stain, no co-staining
Tumor fibrosis
7N/AN/AN/AMisdiagnosis, vision lossCraniotomy, incomplete resectionBenign, diffuse PRL stain, no co-staining
8Cab 3.5 mg/wk for 10 mos1,917
(83% decrease)
23.9
(49% decrease)
CSF leak, DA resistance and intoleranceTranssphenoidal endoscopy, incomplete resectionBenign, diffuse PRL stain, no co-staining, Ki-67 20%
Tumor fibrosis

Tumor volume calculated using geometric formula, volume = ½ (). Cab (cabergoline), DA (dopamine agonist), PRL (prolactin), CSF (cerebrospinal fluid), ACTH (adrenocorticotrophic hormone), GH (growth hormone), TSH (thyroid stimulating hormone).