What Is the Treatment of Prolactinoma?
Clinical Scenario
Prolactinoma is a prolactin-secreting pituitary tumor. This first-line protocol applies regardless of tumor size, addressing elevated prolactin, tumor burden, and impaired gonadal function.
Treatment Approach
The evidence-based approach for prolactinoma centers on dopamine agonist therapy, with cabergoline established as the treatment of choice — applicable to prolactinomas of any size. The full regimen, including selection, sequencing, and monitoring, is available in the complete protocol.
Treatment Goals
- Normalization of prolactin levels
- At least 50% reduction in tumor size
- Restoration of gonadal function
References
DOI: 10.1210/clinem/dgad174
- DA, mainly cabergoline, are now recommended as the treatment of choice to lower PRL levels, decrease tumor size, and restore gonadal function for patients harboring PRL-secreting tumors, regardless of tumor size.
- Cabergoline is strongly recommended as the treatment of choice for prolactinomas of any size, given the proven greater efficacy over different DA either in PRL normalization and tumor shrinkage, although head-to-head comparison studies among different DA formulations are still limited.
- The goals of treatment for prolactinomas include PRL normalization, decrease in tumor size and restoration of gonadal function.
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