Long-term follow-up of transsphenoidal selective adenomectomy for prolactinoma

Although transsphenoidal selective resection of prolactinoma has high cure rates and low morbidity, the frequency of late recurrence of adenoma is controversial. Long-term follow-up data were available on 29 of our patients having initial return to normal prolactin levels after microadenoma resection; in 24, prolactin levels remained normal at 50 ± 3 months' (range, 11 to 81 months) follow-up. Five patients manifested hyperprolactinemia again after intervals of 6 to 16 months. In 5 patients with normal prolactin levels immediately after macroadenoma resection, who were available for long-term follow-up, prolactin levels remained normal in 4 at 41 ± 3 months; one patient had a relapse 78 months after surgery. Testing of prolactin secretory dynamics 6 weeks postoperatively was not predictive of who would suffer relapse. It is not known whether these relapses are due to regrowth of tumor remnants or represent new tumor formation.