Endocrine Abstracts

In prolactinomas, today first choice of treatment is medical treatment with dopamine agonists. Cavernous sinus invasion is not uncommon in prolactinomas and stands out as a blocking factor for surgical removal of the tumor fully. In our study, the presence of cavernous sinus invasion was to investigate the effect on the results of surgical and medical treatment in prolactinomas.

Eighty-seven patients followed up with a diagnosis of prolactinoma were included in the study. Presence or absence of cavernous sinus invasion were defined by examining detailed the coronal images of pituitary magnetic resonance imaging scans. Adenomas that surrounding 67% (2/3) of the internal carotid artery in the cavernous sinus segment were defined as adenomas with cavernous sinus invasion. Respond to treatment determined consider with before and after treatment tumor sizes, prolactin levels and recurrence rates of patients. Accordingly this, remission (tumor shrinkage of at least 50%, normalization of prolactin level) or complete recovery provided that patients respond well to treatment was classified as a group.

In 23 patients with cavernous sinus invasion (CSI group), male/female (M/F) ratio was determined as 16/7 with 37.7 average age at diagnosis and 7/57 with 33.5 average age at diagnosis in 64 patients without invasion (nCSI group). 73.4 and 78.3% of patients respond well to treatment with 70.2 and 69.2% average percentage of reduction in tumor size had been established in CSI and nCSI groups respectively. The percentage of operated patients was found 87% in CSI group while 32.8% in nCSI group. Twenty patients in total of 41 operated patients was in CSI group and only of them was found cured surgically while 10 patients were found cured surgically in nCSI group (P<0.01). The remission rates with surgery were similar in both groups (75 and 81%).

According to our study results, response to medical therapy is not affected by cavernous sinus invasion state but invasion state affects the results of surgical treatment. Accordingly these results, patients with cavernous sinus invasion are not suitable candidates for surgical treatment. When surgical treatment is recommended to prolactinoma patients, cavernous sinus invasion should be considered.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.