東京女子医大病院内分泌センター内科での過去10年間のプロラクチノーマの臨床像

概要

論文の詳細を見る
In a retrospective study of the clinical characteristics of prolactinomas in 61 patients treated in the last 10 years, we found that they occurred more of ten in women than in men and at a younger age. Macroadenoma was significantly more prevalent in men at 85%. The fact that women with a disease duration of >12 years had mostly macroadenoma suggests that such a gender-associated difference may be due to the disease duration. To determine the effectiveness of bromocriptine treatment, we measured prolactin (PRL) after a single dose of bromocriptine. When PRL level cutoff became 30% that of controls and success was evaluated by PRL normalization, the bromocriptine test could predict medication success or failure with 83% accuracy. For successful pregnancy, decreased PRL was favorable, but need not necessarily be normal. Medication was more effective in patients with macroadenoma, with normal PRL response to thyrotropin-releasing hormone (TRH), and in men than women, but cured only a few patients. Medication-induced tumor decrease was not notable. Combined surgery and/or radiotherapy was specially useful in macroadenoma patients who failed to enter remission after monotherapy.
2001-03-25