الورم البرولاكتيني العرضي: ماذا تفعل عندما يفشل علاج ناهض الدوبامين في تطبيع البرولاكتين أو تقليص حجم الورم

References

DOI: 10.1210/jc.2010-1692

1. We recommend dopamine agonist therapy to lower prolactin levels, decrease tumor size, and restore gonadal function for patients harboring symptomatic prolactin-secreting microadenomas or macroadenomas.
2. For symptomatic patients who do not achieve normal prolactin levels or show significant reduction in tumor size on standard doses of a dopamine agonist (resistant prolactinomas), we recommend that the dose be increased to maximal tolerable doses before referring the patient for surgery.
3. Dose increases should be stepwise and guided by prolactin levels.
4. We recommend that patients resistant to bromocriptine be switched to cabergoline.
5. Dopamine agonist resistance includes a failure to achieve a normal prolactin level on maximally tolerated doses of dopamine agonist and a failure to achieve a 50% reduction in tumor size.