REZUMAT

In women with micro- or small infrasellar or inferiorly extending macroprolactinomas, treatment with bromocriptine has been suggested to restore fertility. Following conception, therapy is discontinued, and reinitiated only if symptoms of tumor growth develop. In women with larger macroprolactinomas, the optimal choice of treatment is more difficult to determine. One should advocate the patient to aim at maximal tumor size reduction by medical treatment prior to pregnancy. Following conception, treatment with bromocriptine may be stopped or continued during pregnancy, depending on the aggressiveness of the tumor. If symptoms of tumor re-growth develop in the former, therapy may be reinitiated. If medical treatment fails, surgery is recommended. Breast feeding is possible in women with prolactinomas. Prolactinomas are generally classified according to size. Microprolactinomas are less than 10 mm in size, whereas macroprolactinomas are at least 10 mm in size. Macroprolactinomas can be intrasellar or can extend into the extrasellar neighborhood and invade the dura, sphenoid bone, cavernosus sinuses, the suprasellar cisterns, and the adjoining parts of the brain. Prolactinomas larger than 4 cm in diameter and/or with massive extrasellar extension may be termed “gian