Treatment of resistant prolactinoma: case report

I.A. Matsueva, K.A. Golovatyuk, L.V. Belousova, U.A. Tsoi, E.N. Grineva 

V.A. Almazov National Medical Research Center, St. Peterburg

Management of a dopamine agonist-resistant prolactinoma persisting despite various treatment options is very challenging and may vary depending on a clinical situation.

The clinical case describes one of potential options for management of a patient with a dopamine agonist-resistant prolactinoma and persistent hyperprolactinemia who underwent repeated pituitary surgery and stereotactic radiosurgery. Typically, radiatiotherapy is considered as the most appropriate treatment option for patients with a postoperative tumor growth. In clinical practice, dopamine agonist therapy is reinitiated in terms of a patient’s symptoms and condition. Several issues such as a risk of tumor growth associated with potential chiasm compression and hyperprolactinemia symptoms should be considered.

Close monitoring of a patient with persistent hyperprolactinemia after radiotherapy subject to lack of clinically significant manifestations of hyperprolactinemia, adenoma reduction signs, and appropriate replacement therapy for hypopituitarism, may be an alternative to dopamine agonist therapy or other methods to reduce prolactin level.

Keywords: neuroendocrine tumor, resistant prolactinoma, transsphenoidal adenomectomy, stereotactic radiotherapy, dopamine agonists.

For citation: Matsueva I.A., Golovatyuk K.A., Belousova L.V., Tsoi U.A., Grineva E.N. Treatment of resistant prolactinoma: case report. RMJ. 2025;2:–30. DOI: 10.32364/2225-2282-2025-2-5