Prolactinomas are the most frequent occurring functioning pituitary tumours. After many years of considering dopamine agonist as a first-line treatment option for all kinds of prolactinoma the new Pituitary Society guideline marks a new era in the management of prolactinoma. How to choose between a predominantly safe and effective medical strategy and a surgical procedure?
During the presentation I will address epidemiological and historical aspects of prolactinoma management. Patient centered aspects will be discussed such as quality of life, treatment preference, cognitive function and drug side effects. Both treatment outcomes are reviewed.
What are caveats of both treatment options? How can surgery and counseling for a potential surgical intervention be incorporated in the care path. This is a particular challenge since not all cases are seen in surgical pituitary centers, not even always by endocrinologists.
The presenter is principle investigator of the Dutch Prolactinoma Studies. This is a prospective comparative study between surgical counseling and medical treatment in patients with a limited prolactinoma, which is still underway but nevertheless we can share interesting insights since the conception and conduction of this trial already changed our practice.