Introduction

Microprolactinomas are typically treated with dopamine agonists. However, data on the outcomes of patients treated with surgery remain limited. This study presents a large series of patients who underwent pituitary surgery for microprolactinomas and evaluates the efficacy and safety of this approach.

A Cohort Study on Microprolactinoma Surgery

Between January 2008 and October 2020, 114 adult patients with microprolactinomas underwent surgery in a specialized neurosurgical center. The technique used was an endoscopic endonasal transsphenoidal approach. Patients included in the study had a microprolactinoma with no evident cavernous sinus invasion on MRI. Prolactin levels were measured before and after surgery.

Study Results

🔹 Median follow-up: 18.2 months (ranging from 2.8 to 155 months)
🔹 Cure rate: 88% of patients achieved remission after surgery.
🔹 Disease-free survival rate: 90.9% at 1 year and 81% at 5 years.
🔹 Predictive factor for remission: Preoperative prolactin levels were a key indicator of surgical success. `
🔹 Rare postoperative complications: No severe pituitary deficiency was observed, with only one case of diabetes insipidus and one cerebrospinal fluid leakage, both successfully treated
.

Conclusion

For well-selected patients, pituitary surgery performed by a specialized team is an effective and safe alternative to dopamine agonists for the treatment of microprolactinomas.