Prolactinomas : clinical studies

Abstract

Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An increased risk of cardiac valve disease has been reported in patients treated with cabergoline for Parkinson__s disease. Stimulation of serotonin receptors on cardiac valves by dopamine agonists results in fibrotic changes. The study described in chapter 3, assesses prevalence of valve regurgitation in patients treated for prolactinomas. Many patients with pituitary diseases suffer from decreased quality of life. Although prolactinomas present with emotional disturbances, quality of life has not been assessed in these patients. The study described in chapter 4, assesses quality of life in patients treated for microprolactinomas using four health-related questionnaires. The study described in chapter 5 compares quality of life, adjusted for age and gender, of patients after treatment for different pituitary adenomas. Malignant prolactinoma is rare manifestation, diagnosed at moment metastasis occur. The study described in chapter 6 evaluates history of patient with malignant prolactinoma, and provides an overview of radiological and histological characteristics and treatment of all cases with malignant prolactinomas published in literature.