La chirurgia del prolattinoma: un cambio di paradigma?

Prolactinomas are pituitary adenomas characterised by hypersecretion of prolactin. This results in the onset of hypogonadism and, depending on the size of the mass, symptoms related to compression of parasellar structures. Medical therapy with dopamine agonists (DA) has been the treatment of choice for regression of the changes brought about by prolactinomas for about half a century, while surgical therapy is only reserved for special cases. However, the advancement of surgical techniques, with the possibility of using precision instrumentation supported by dedicated software, now rightfully allows us to consider surgery, in patients with small, included, non-invasive prolactinomas, performed by experienced operators in high-volume dedicated centres, a viable alternative to DA even as first-line treatment as it is able to bring about the patient’s recovery.