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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 754-758
DOI: 10.4103/ajns.AJNS_127_19
Original Article

Pituitary prolactinoma with amyloid deposits: Surgery or dopamine agonists? Review of previous reports and new recommendations for management

Santosh Prabhu
Department of Neurosurgery, Western India Institute of Neurosciences, Kolhapur, Maharashtra
,
Sujata Prabhu
1   Department of Neuroanesthesia, Western India Institute of Neurosciences, Kolhapur, Maharashtra
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Background: Pituitary adenomas, macro and micro, are a common occurrence in most neurosurgical centers. Prolactinomas are the most common pituitary tumors and are often treated nowadays with dopamine agonists such as cabergoline, with good results. Aims and Objectives: To suggest new therapeutic guidelines for treating Prolactinomas with Amyloid deposits on preoperative detection of Amyloid deposition in Pituitary tumors, based on MRI characteristics. Materials and Methods: We report a case of a pituitary prolactinoma with amyloid deposits in a 45-year-old male who underwent a transsphenoidal excision of the adenoma. Although on magnetic resonance imaging scans, no amyloid was reported, at histopathology, spherical amyloid within the pituitary tumor was found in abundance. The patient underwent surgery without any trial of cabergoline due to rapid deterioration of vision. Conclusion: Prolactinomas with amyloid deposits are known not to respond to dopamine agonists (cabergoline) by a reduction in size and may ,in fact increase in volume. Therefore, we recommend that in prolactinomas not responding to medical therapy, deposition of amyloid has to be considered as a cause for failure of medical therapy and surgery and then has to be offered pronto.

Key-words:

Amyloid - cabergoline - prolactin - pituitary tumor

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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