postmenopausal women with prolactinomas may present withheadaches and visual field disturbances are commonspace occupying effectsmen with prolactinomas may present witherectile dysfunction, diminished libido, and occasionally gynecomastiaspace occupying effects of pituitary tumorsCSF rhinorrhea (sella turcica or sphenoid sinus)unilateral defects CN III, IV, VI and ophthalamic & maxillary branches of V (cavernous sinuses)bi-temporal heminopsia (optic chiasm)headaches and pituitary insufficiencywhen do you order an MRI evaluation of the pituitary on a patient with hyperprolactinemiawhen all other possible causes have been ruled outfirst thing you treat in a patient with prolactinomathe underlying problemie- if TSH is increased, fix that 1st... then continue onwhat is the medical treatment of choice for prolactinomascabergoline and bromocriptinedopamine agonist80% of patients will experience normal prolactin levels with therapywhen would you utilize the surgical option of traanssphenoid surgery on a patient with a prolactinomatumors are unresponsive to medical therapytumors affect visual fieldtumor exhibits apoplexypt is intolerant or refuses medical therapywhen should radiation therapy be utilized on a patient with a prolactinoma
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- Fall '09
- Cortisol, Pituitary adenoma, Acromegaly