Surgical Management of Giant Prolactinomas: A Descriptive Study

Table 3

Postoperative treatment course for patients with giant prolactinoma.

Case no	Postoperative PRL at 1 week (μg/L)	Postoperative central hormone deficit(s)^†	Postoperative PRL nadir (μg/L) with DA	Time from surgery to remission (months)	DA adverse effects	Other outcomes and therapies	Duration of follow up (years)
1	4,962	Hypogonadism, hypothyroidism, adrenal insufficiency, diabetes insipidus (transient)	6; (Bromo 2.5 mg/day)	63	Worsening mental health, psychosis	N/A	5
2	368	Hypogonadism, hypothyroidism, adrenal insufficiency	2,106; (Cab 1 mg/wk)	N/A – not achieved	Psychosis, hypersexuality	Vision improved; Stopped DA for adverse effects, declined radiation	5
3	63	Hypogonadism, hypothyroidism, adrenal insufficiency, diabetes insipidus	7; (Cab 1 mg/wk)	36 (0.5 from second surgery)	N/A	3 years later had another surgery: craniotomy to further debulk (growing tumor). Deceased	3
4	93	Hypogonadism, hypothyroidism, adrenal insufficiency	86; (Cab 0.5 mg/wk)	N/A–not achieved	Headache, CSF leak	Vision improved. Surgery complicated by right hemiparesis. Had radiation	6
5	184	Hypogonadism, hypothyroidism	13; (Cab 5.25 mg/wk)	15 (13 from second surgery)	N/A	2 months later had another surgery: craniotomy to further debulk	6
6	3,065	Hypogonadism, hypothyroidism, adrenal insufficiency	128; (Cab 3.5 mg/wk)	N/A–not achieved	Lightheadedness, worsening memory	Vision improved. Had radiation	5
7	11,485	Hypogonadism, hypothyroidism	5; (Cab 2 mg/wk)	14	N/A	N/A	6
8	298	Hypogonadism	1; (Cab 3 mg/wk)	43	CSF leak	Vision improved	13

^†Growth hormone deficiency was not tested in any patient. PRL (prolactin), DA (dopamine agonist), Bromo (bromocriptine), Cab (cabergoline), CSF (cerebrospinal fluid).