Background:Prolactinoma represent approximately 30% of pituitary adenomas, they are the most common type of functioning pituitary adenoma, few studies have recently reexamined efficacy of transsphenoidal surgery in prolactinoma.
Objective: The aim of this work is to evaluate the outcome of patients with prolactinoma treated by transsphenoidal surgery, to identify the factors that affect the surgical outcome leading to remissions or recurrence.
Patients and Methods: This is a retrospective study of 27 patients with prolactinoma treated in neurosurgery department in Benha university in the period between january 2015 and january 2018of which 21 were women and 6 were men, the mean age was 40(+-) 15 years.
Results: Postoperative remission was obtained in 70% of cases. Better outcome was associated withsmaller preoperative tumor size, amount of removed tumor intraoperatively, lack of invasion of nearby structures and lack of suprasellar extension .The mean follow up period was 36 months. Recurrence was observed in 20% of cases during this period (5 cases). In patients with preoperative dopamine agonist resistance treated again after surgery there was significant reduction of prolactin level in about half of cases.
Conclusion: Gross total removal,smaller tumor size, lack of cavernous sinus invasion and lack of suprasellar extension is associated with better outcome. Dopamine agonist resistant cases show better response to dopamine agonist after debulking.