A 35-year-old female patient is diagnosed with a pituitary prolactinoma. She presents with symptoms of amenorrhea and galactorrhea, and imaging confirms a pituitary tumor secreting excess prolactin.
What is the treatment of choice for pituitary prolactinomas?
A. Surgery
B. Radiotherapy
C. Surgery followed by radiotherapy
D. Dopamine agonists
The Correct Answer: D. Dopamine agonists
Explanation:
– Dopamine Agonists (D): The first-line treatment for pituitary prolactinomas is dopamine agonists, such as cabergoline or bromocriptine. These medications are effective in lowering prolactin levels and shrinking the tumor in most cases. They are usually preferred due to their non-invasive nature and proven efficacy in managing prolactinomas.
Explanation of Other Options:
– Surgery (A): Surgery may be considered if dopamine agonists are not effective or if there is a need to address significant symptoms or complications caused by the tumor. However, it is not the first-line treatment.
– Radiotherapy (B): Radiotherapy is typically reserved for cases where the tumor is resistant to medical therapy and surgery, or when surgery is not feasible. It is not the initial treatment of choice.
– Surgery followed by Radiotherapy (C): This combination is not the standard approach for initial treatment. It may be used in more complex cases where other treatments have failed.
In summary, dopamine agonists are the treatment of choice for pituitary prolactinomas due to their effectiveness in controlling prolactin levels and reducing tumor size.