Endocrine Abstracts

Introduction: The prolactinoma is the most common functioning pituitary tumour. There are few long-term studies on the optimal duration of treatment with dopamine agonists prolactinoma to ensure healing without recurrence after stopping the medication and do not provide a consensus on it or on withdrawal criteria treatment.

Objectives: To establish the prevalence of withdrawal of treatment macroprolactinomas and evaluate criteria prolactinoma cure medical treatment and analysing the possible factors involved.

Methods: Retrospective study of 77 patients diagnosed and treated for prolactinoma in the Service Endocrinology of University Hospital of Asturias, from 1982 to 2012. Only 56 patients were treated exclusively with dopamine agonists and the rest were excluded. Of these 40 patients continue with treatment and 16 patients were withdrawn from treatment (eight men and eight women) after verifying the suppression of prolactin (PRL) levels and the disappearance of the pituitary mass. In 28.6% removal treatment and 44.6% could meet criteria.

Results: The withdrawal of treatment was on average after 11.01±7.36años (2.26–26.8) normalization of prolactin. After removal medical treatment was resumed in 50% patients at 1, 6, 12, and 60 months respectively. The cause of restarting treatment was in all the elevation of plasma PRL levels. No significant differences between withdrawal and not withdrawn for age, sex, prolactin levels presuspension, initial tumour size, type of response, and dose of agonist withdrawal.

Conclusions: Following the withdrawal of treatment with dopamine agonists after an average of 10 years under normal PRL and almost complete tumour shrinkage was reintroduce 50% of the patients in our series. Re-introduction why treatment was in all cases prolactin elevation. No tumour regrowth in any of the control images. We observed no relation to either the initial size nor PRL figures presuspension or other predictors by the limited sample size.