Surgical Outcome of Endoscopic Transsphenoidal Surgery in Prolactinoma

Abstract 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 prolactin-oma. Aim of Study: The aim of this work is to evaluate the outcome of patients with prolactinoma treated by transsphe-noidal 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 2018 of which 21 were women and 6 were men, the mean age was 40(±) 15 years. Results: Post-operative remission was obtained in 70% of cases. Better outcome was associated with smaller pre-operative tumor size, amount of removed tumor intraopera-tively, 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 pre-operative dopamine agonist resistance treated again after surgery there was signif-icant 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.