Pituitary prolactinoma is a type of pituitary adenoma. The patient's pituitary gland secretes excessive prolactin, leading to symptoms such as amenorrhea, galactorrhea, and infertility. In the past decade, drug therapy has become the preferred treatment for pituitary prolactinoma in clinical practice, and it has become a common understanding among neurosurgeons. Professor Wu Zhebao, Director of the Diagnosis and Treatment Center for Pituitary Prolactin Adenoma at Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine (hereinafter referred to as Ruijin Hospital), introduced in an interview with China News Network on the 22nd that this treatment concept is quietly changing: specific types of pituitary tumors should be treated with surgery as the first choice. It is understood that as one of the experts in the field of pituitary tumors, Professor Wu Zhebao participated in the review and revision of the article "Diagnosis and Management of Prolactin Secreting Pituitary Adenoma: a Pituitary Society International Consensus Statement" written by the International Pituitary Association in 2023. This international consensus statement is published by the authoritative international journal Nature Reviews Endocrinology. At the same time, the magazine also published a communication article written by Professor Wu Zhebao titled "The shift of therapeutic strategy for prolactinomas: surgery as the first line option". It is understood that in 2006 and 2011, the International Pituitary Society developed and released two guidelines (expert consensus) for prolactinoma and hyperprolactinemia, clearly stating that dopamine receptor agonists are the preferred drug for prolactinoma treatment, and surgical treatment is only applicable to those who are resistant or intolerant to drug side effects, drug-induced tumor stroke or cerebrospinal fluid leakage, and those who are contraindicated by drugs with accompanying psychiatric symptoms. Professor Wu Zhebao pointed out that among the many changes in the consensus statement just released, the biggest change is that it clarifies that prolactin microadenomas and well encapsulated/well-defined large adenomas should be treated as first-line surgery. "This significant change in treatment has been determined through international consensus and has strong clinical guidance significance," said the expert bluntly. He explained that in clinical practice, cystic tumors have poor drug treatment effects, and patients face the disadvantages of drug side effects and long-term or even lifelong medication; For women in their reproductive period, if they become pregnant during medication, it can lead to serious problems such as tumor enlargement, decreased vision, and loss of vision, and the impact of medication on the fetus is unknown. Professor Wu Zhebao introduced that at the same time, the efficacy of endoscopic surgery for transsphenoidal pituitary tumors has significantly improved, with clear boundaries and intact tumor capsule, and a clear boundary with normal pituitary gland, sellar diaphragm, and cavernous sinus. The probability of complete resection is very high
Edit：GuoGuo Responsible editor：FangZhiYou
Source：people.cn
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