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Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma

Section of Neurosurgery

A large proportion of prolactin secreting tumours of the pituitary gland are treatable by dopamine agonist drugs. however certain subgroups of these patients are better managed by surgical excision. the indications for surgery in prolactinomas remain controversial and this paper attempts to clarify these with illustrative cases. the factors favouring a surgical approach include poor tolerance of long term medical therapy, progression of visual deficits or recurrence while on medical treatment, cystic change in the tumour with pressure effects, csf fistula secondary to tumour shrinkage and prophylactic surgery in tumours anticipated to cause csf leak following medical therapy. the size …